Tuesday, June 19, 2007

Extended Pill Regimens

The good and the bad:

Good. Effective long-term treatment for hormone withdrawal symptoms, such as headaches, pelvic pain and mood swings, that occur on 21/7 regimens. [The symptoms respond relatively quickly to an extended regimen with maximal improvement usually seen within the first few weeks with persistent long-term improvement.]

Bad. Breakthrough bleeding/spotting (BTB/BTS) can be a problem for some patients.

Note the BTB/BTS remedy:

[If] BTB/BTS is problematic, improvement continues as the duration of extended use lengthens with institution of a 3-day HFI* [hormone-free interval] effective management in the majority.

*In other words, if you're on an extended regimen and you experience BTB/BTS, stop taking the Pill for 3 days, then restart (after consulting with your Ob/Gyn, of course).


At 10:57 PM, Anonymous Anonymous said...

Do you have an citations for the "BTB/BTS remedy" you describe? I'm having that problem big time (I'm well over 40 straight days of BTB). There doesn't seem to be any harm in doing what you suggest, but I'd be interested in any formal research you're aware of. Thanks!

At 4:08 AM, Blogger ema said...


From the study linked:

The findings indicated that 53.7% of subjects had no breakthrough bleeding or breakthrough spotting (BTB/BTS) during any given 28-day interval of the extended regimen. BTB/BTS decreased in the second half compared to the first half of the extended regimen. To manage BTB/BTS, instituting a 3-day hormone-free interval (HFI) was significantly more effective than continuing OCs (p<.001). At the 6-month follow-up, most subjects had continued the extended regimen on their own with a high level of satisfaction.


An extended OC regimen containing DRSP/EE significantly improved mood, headaches and pelvic pain scores throughout the 1 year of use, compared to a 21/7 cycle. Sustained BTB/BTS episodes occurred in 45 subjects (56%), decreasing in the second half of the study and effectively managed with a 3-day HFI.

Coffee AL, Sulak PJ, Kuehl TJ. Long-term assessment of symptomatology and satisfaction of an extended oral contraceptive regimen.

At 4:12 AM, Blogger ema said...

Ugh, the last part was cut off. That's: Contraception Volume 75, Issue 6, Pages 444-449 (June 2007)

At 9:00 PM, Blogger Sascha Rybinski said...

I tried this and it worked like a charm.


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