Three-day hormone-free interval eases breakthrough bleeding from extended-use OCs

Women who are on a 168-day extended oral contraceptive regimen and experience breakthrough bleeding for 7 days or more do better with a 3-day hormone-free interval rather than continuing hormones, according to the results of a study published in the October issue of the American Journal of Obstetrics & Gynecology.

Patricia J. Sulak, MD, of the Department of Obstetrics and Gynecology at Scott & White Clinic in Temple, Tex., and colleagues studied 111 patients who initiated an extended OC regimen of 3 mg of drosperinone and 30 μg of ethinyl estradiol. Patients were randomized to either a 3-day hormone-free interval or continuing to take active pills if they experienced 7 days of breakthrough bleeding or spotting.

Among the 102 patients who completed the regimen, the researchers found that those with a heavier daily flow rating during the pre-extension cycle had greater daily flow ratings and earlier occurrence of breakthrough bleeding during the extended regimen than those with lighter daily flow ratings. They also found a 3-day hormone-free interval was significantly more effective in resolving breakthrough bleeding and breakthrough spotting than continuing active pills.

Funding was provided by Berlex Laboratories.

Sulak PJ, Kuehl TJ, Coffee A, et al. Prospective analysis of occurrence and management of breakthrough bleeding during an extended oral contraceptive regimen. Am J Obstet Gynecol. 2006;195:936-941.