Bleeding patterns in users of a continuous contraceptive combination containing ethinyl-estradiol and gestodene

Bleeding patterns in users of a continuous contraceptive combination

containing ethinyl-estradiol and gestodene

R.B. Machado, P. Fabrini, E.M.C. Maia, F.G. Tachotti, E.M.P. Pádua, A.M.


Department of Obstetrics and Gynecology, Faculty of Medicine, Jundiaí,

São Paulo, Brazil

Objective: The objective of this study was to evaluate bleeding

patterns during continuous use of a combined oral contraceptive pill containing

ethinyl-estradiol and gestodene.

Methods: Thirty-two patients with mean age of 25.0+3.7 years

were evaluated in an open, prospective, non-comparative study. Patients used the

contraceptive combination of ethinyl-estradiol 30 mcg and gestodene 75 mcg

continuously for six consecutive months. Any occasional bleeding was classified

as spotting, light, moderate or heavy bleeding. Spotting was defined as very

light bleeding when a change of sanitary protection was not required. The

occurrence of any bleeding outside the patient’s usual bleeding pattern was

defined as light, moderate or heavy bleeding based for comparison on the

parameters presented by the patient from previous menstrual cycles. For data

analysis, the 6-month duration of the study was divided into six periods of 28

days of continuous contraceptive use, referred to as Cycle 1 – Cycle 6. The

mean number of days of any kind of bleeding was calculated for each cycle.

Analysis of variance (ANOVA) was used in the statistical analysis to compare the

mean number of bleeding days in the six cycles studied.

Results: The majority of patients presented no bleeding during the

evaluation period. At the end of the sixth cycle of continuous use, 82% of

patients reported no bleeding. The most common type of bleeding was spotting,

reported by 41% of patients, most frequently during the third cycle of use. The

mean duration of spotting was 3.1+6.3 days (p=0.002 when compared to

Cycles 1, 4, 5 and 6). Overall bleeding rate was also greater in the third cycle

with a mean of 5.8+9 days (p=0.001 compared to Cycles 1, 5 and 6). After

the fourth cycle of use, there was a reduction in the overall bleeding rate and

an increase in the rate of amenorrhea.

Conclusion: The continuous use of an oral contraceptive containing

ethinyl-estradiol and gestodene was associated with an acceptable bleeding

pattern consisting principally of spotting. The rates of amenorrhea were high

after the fourth month of use.

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