Menstrual Impact of Contraception

Document Type

Article

Publication Date

5-1994

Institution/Department

Obstetrics and Gynecology

Journal Title

American Journal of Obstetrics and Gynecology

MeSH Headings

Contraceptive Agents (adverse effects); Contraceptives, Oral, Hormonal (adverse effects); Female; Humans; Menstruation Disturbances (chemically induced)

Abstract

Persistent bleeding is a common reason for the discontinuation of contraception. Standard terminology for describing bleeding patterns by reference period is presented. Observed bleeding patterns with oral contraceptives, depot medroxyprogesterone acetate, the levonorgestrel subdermal implant, and intrauterine devices are described. Bleeding days are least with oral contraceptives that are highest in progestin and estrogen potency and dose, but the ratio of the two steroids is also important. Published studies suggest that oral contraceptives containing new nonandrogenic progestins have bleeding patterns as acceptable as older low estrogen formulations. Approaches to the evaluation and treatment of intermenstrual bleeding with contraceptive methods are reviewed. Patient education on expected bleeding patterns is essential to compliance and continuation.

ISSN

0002-9378

First Page

1513

Last Page

22

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