Ethinylestradiol 30microgram / Gestodene 100microgram tablets

Objective: A systematic review was carried out of studies of women with endometriosis, to examine the evidence for efficacy of the use of hormonal contraception to improve disease-related pain and decrease postoperative risk of disease recurrence. Methods: A search of the Medline/PubMed and Embase databases was performed to identify all published English language studies on hormonal contraceptive therapies (combined hormonal contraceptives [CHCs], combined oral contraceptives [COCs], progestin-only pills [POPs] and progestin-only contraceptives [POCs]) in women with a validated endometriosis diagnosis, in comparison with placebo, comparator therapies or other hormonal therapies. Main outcome measures were endometriosis-related pain (dysmenorrhoea, pelvic pain and dyspareunia), quality of life (QoL) and postoperative rate of disease recurrence during treatment. Results: CHC and POC treatments were associated with clinically significant reductions in dysmenorrhoea, often accompanied by reductions in non-cyclical pelvic pain and dyspareunia and an improvement in QoL. Only two COC preparations (ethinylestradiol [EE]/norethisterone acetate [NETA] and a flexible EE/drospirenone regimen) demonstrated significantly increased efficacy compared with placebo. Only three studies found that the postoperative use of COCs (EE/NETA, EE/desogestrel and EE/gestodene) reduced the risk of disease recurrence. There was no evidence that POCs reduced the risk of disease recurrence. Conclusions: CHCs and POCs are effective for the relief of endometriosis-related dysmenorrhoea, pelvic pain and dyspareunia, and improve QoL. Some COCs decreased the risk of disease recurrence after conservative surgery, but POCs did not. There is insufficient evidence, however, to reach definitive conclusions about the overall superiority of any particular hormonal contraceptive

Abstract licence: CC BY

Purpose: Due to the scarce information available in Brazil in relation to the number of women who initiated the use of combined oral contraceptives and prematurely discontinued, the objective was to assess the reasons for discontinuation of the use of several combined oral contraceptives among Brazilian women living in urban areas. Methods: A cross- sectional study with 400 gynecologists registered with the Brazilian Federation of Obstetricians and Gynecologists. Each physician interviewed 10 non-pregnant, not breastfeeding, not amenorrheic women aged 18 to 39 years who consulted requesting combined oral contraceptive (COC) with a questionnaire at the beginning of use and at six months later. The questionnaire included sociodemographic data, type of COC chosen or prescribed and reasons for discontinuation when it occurred during follow-up. The strategy of selection allowed the inclusion of women from different socioeconomic strata, however, only those attended at private or insurance offices. The sample size was estimated at 1,427 women. Results: A total of 3,465 interviews were conducted at the first visit and 1,699 six months later. The women were 20 to 29 years old, 57.3% were single and an equal proportion of 45.0% attended high school or college. Most (60.7%) were nulligravidas and among those who had used some contraceptive before, 71.8% had used a COC. Among the more prescribed or chosen COC the most prevalent were monophasic with ethynil estradiol (20 μg) and regarding progestin the most prevalent was with gestodene (36.5%) followed by a COC with drosperinone (22.0%). At six months 63.5% still used COC. Among those who discontinued the main reasons were wishing to become pregnant (36.5%) and side effects (57.3%) and the most prevalent were headache (37.6%), weight gain (16.6%) and irregular bleeding (23.6%). CONCLUSIONS: The continuation rate of COC was low at six months and this study could contribute to a better counseling on the part of physicians of patients who initiate COC about side-events that are rare, minimal and temporary and about the benefits of COC use.336303309(2008) Data Sheet. Washington, , Population Reference Bureau. Family planning worldwide -, DC): Population Reference Bureau, 2008Gilliam, M., Knight, S., McCarthy Jr., M., Success with oral contraceptives: A pilot study (2004) Contraception, 69 (5), pp. 413-418Fu, H., Darroch, J.E., Haas, T., Ranjit, N., Contraceptive failure rates: New estimates from the 1995 National Survey of Family Growth (1999) Fam Plann Perspect, 31 (2), pp. 56-63Trussell, J., Contraceptive efficacy (2007) Contraceptive Technology, pp. 747-826. , In: Hatcher RA, Trussell J, Nelson AL, Cates W, Stewart FH, Kowal D, editors, 19th ed. New York: Ardent MediaDavie, J.E., Walling, M.R., Mansour, D.J., Bromham, D., Kishen, M., Fowler, P., Impact of patient counseling on acceptance of the levonorgestrel implant contraceptive in the United Kingdom (1996) Clin Ther, 18 (1), pp. 150-159Mansour, D., Bahamondes, L., Critchley, H., Darney, P., Fraser, I.S., The management of unacceptable bleeding patterns in etonogestrel-releasing contraceptive implant users (2011) Contraception, 83 (3), pp. 202-210Rosenberg, M.J., Waugh, M.S., Burnhill, M.S., Compliance, counseling and satisfaction with oral contraceptives: A prospective evaluation (1998) Fam Plann Perspect, 30 (2), pp. 89-92Rosenberg, M.J., Waugh, M.S., Causes and consequences of oral contraceptive noncompliance (1999) Am J Obstet Gynecol, 180 (SUPPL. 2), pp. 276-279Schwartz, J.L., Creinin, M.D., Pymar, H.C., Reid, L., Predicting risk of ovulation in new start oral contraceptive users (2002) Obstet Gynecol, 99 (2), pp. 177-182Leite, I.C., Gupta, N., Assessing regional differences in contraceptive discontinuation, failure and switching in Brazil (2007) Reprod Health, 4, p. 6Gallo, M., Nanda, K., Grimes, D.A., Schulz, K.F., Twenty micrograms vs >20 microg estrogen oral contraceptives for contraception: Systematic review of randomized controlled trials (2005) Contraception, 71 (3), pp. 162-169Marinho, L.F., Aquino, E.M.L., Almeida, M.C., Práticas contraceptivas e iniciação sexual entre jovens de três capitais brasileiras (2009) Cad Saúde Pública, 25 (2 SUPPL.), pp. 227-239Grimes, D.A., Forgettable contraception (2009) Contraception, 80 (6), pp. 497-499Lopez, L.M., Hiller, J.E., Grimes, D.A., Education for contraceptive use by women after childbirth (2010) Cochrane Database Syst Rev, 1. , CD001863Blanc, A.K., Curtis, S.L., Croft, T.N., Monitoring contraceptive continuation: Links to fertility outcomes and quality of care (2002) Stud Fam Plann, 33 (2), pp. 127-140Hooper, D.J., Attitudes, awareness, compliance and preferences among hormonal contraception users: A global, cross-sectional, self-administered, online survey (2010) Clin Drug Investig, 30 (11), pp. 749-763Halpern, V., Lopez, L.M., Grimes, D.A., Gallo, M.F., Strategies to improve adherence and acceptability of hormonal methods of contraception (2011) Cochrane Database Syst Rev, 4. , CD004317Draper, B.H., Morroni, C., Hoffman, M., Smit, J., Beksinska, M., Hapgood, J., Depot medroxyprogesterone versus norethisterone oenanthate for long-acting progestogenic contraception (2006) Cochrane Database Syst Rev, 3. , CD005214Gaudet, L.M., Kives, S., Hahn, P.M., Reid, R.L., What women believe about oral contraceptives and the effect of counseling (2004) Contraception, 69 (1), pp. 31-36McLaurin, V.L., Dunson, B.A., Dunson, T.R., A comparative study of 35 mcg and 50 mcg combined oral contraceptives: Results from a multicenter clinical trial (1991) Contraception, 44 (5), pp. 489-503Koetsawang, S., Charoenvisal, C., Banharnsupawat, L., Singhakovin, S., Kaewsuk, O., Punnahitanont, S., Multicenter trial of two monophasic oral contraceptives containing 30 mcg ethinylestradiol and either desogestrel or gestodene in Thai women (1995) Contraception, 51 (4), pp. 225-229Archer, D.F., Maheux, R., Delconte, A., O'Brien, F.B., A new low- dose monophasic combination oral contraceptive (Alesse) with levonorgestrel 100 μg and ethinyl estradiol 20 μg (1997) Contraception, 55 (3), pp. 139-144. , North American Levonorgestrel Study Group (NALSG)Westhoff, C.L., Heartwell, S., Edwards, S., Zieman, M., Stuart, G., Cwiak, C., Oral contraceptive discontinuation: Do side effects matter? (2007) Am J Obstet Gynecol, 196 (4), pp. 1-6. , 412Larsson, G., Blohm, F., Sundell, G., Andersch, B., Milsom, I., A longitudinal study of birth control and pregnancy outcome among women in a Swedish population (1997) Contraception, 56 (1), pp. 9-16Continuation rates for oral contraceptives and hormone replacement therapy (2000) Hum Reprod, 15 (8), pp. 1865-1871. , The ESHRE Capri Workshop GroupRosenberg, M.J., Waugh, M.S., Meehan, T.E., Use and misuse of oral contraceptives: Risk indicators for poor pill taking and discontinuation (1995) Contraception, 51 (5), pp. 283-288Rosenberg, M.J., Waugh, M.S., Oral contraceptive discontinuation: A prospective evaluation of frequency and reasons (1998) Am J Obstet Gynecol, 179 (3), pp. 577-582Murphy, P.A., Brixner, D., Hormonal contraceptive discontinuation patterns according to formulation: Investigation of associations in an administrative claims database (2008) Contraception, 77 (4), pp. 257-263Peipert, J.F., Zhao, Q., Allsworth, J.E., Petrosky, E., Madden, T., Eisenberg, D., Continuation and satisfaction of reversible contraception (2011) Obstet Gynecol, 117 (5), pp. 1105-1113Skjeldestad, F.E., Increased number of induced abortions in Norway after media coverage of adverse vascular events from the use of third-generation oral contraceptives (1997) Contraception, 55 (1), pp. 11-14Philipson, S., Wakefield, C.E., Kasparian, N.A., Women's knowledge, beliefs, and information needs in relation to the risks and benefits associated with use of the oral contraceptive pill (2011) J Womens Health (Larchmt), 20 (4), pp. 635-64

Abstract licence: CC BY-NC