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Combined oral contraceptives (COCs) can be used to treat menstrual cycle disorders including heavy menstrual bleeding, [9] and pelvic pain disorders such as endometriosis [10] and dysmenorrhea. [11] CHCs are also a first line treatment for polycystic ovary syndrome for menstrual abnormalities, acne, and hirsutism. [12]
Extended or continuous cycle combined oral contraceptive pills are a packaging of combined oral contraceptive pills (COCPs) that reduce or eliminate the withdrawal bleeding that would occur once every 28 days in traditionally packaged COCPs. It works by reducing the frequency of the pill-free or placebo days.
Hormonal therapies to reduce or stop menstrual bleeding have long been used to manage a number of gynecologic conditions including menstrual cramps (dysmenorrhea), heavy menstrual bleeding, irregular or other abnormal uterine bleeding, menstrual-related mood changes (premenstrual syndrome or premenstrual dysphoric disorder), and pelvic pain due to endometriosis or uterine fibroids.
Oral contraceptives are prescribed in the treatment of menorrhagia to help regulate menstrual cycles and prevent prolonged menstrual bleeding. The hormonal IUD ( Mirena ) releases levonorgestrel which thins the uterine lining, preventing excessive bleeding and loss of iron.
Understanding the underlying cause of bleeding is an important part of determining the best next step for treatment in each patient's circumstance. Generally, the treatment of abnormal uterine bleeding focuses on controlling the current episode of bleeding and reducing further blood loss in future menstrual cycles or acute episodes. [citation ...
Dienogest is used primarily in birth control pills in combination with ethinylestradiol under the brand name Valette. [24] [7] [25] It is also available in a quadriphasic birth control pill combined with estradiol valerate, marketed as Natazia in the United States and Qlaira in some European countries and Russia. [26] [27] [28]
MPA is the most widely used progestin in menopausal hormone therapy and in progestogen-only birth control. [17] [18] DMPA is approved for use as a form of long-acting birth control in more than 100 countries. [19] [20] In 2022, it was the 276th most commonly prescribed medication in the United States, with more than 800,000 prescriptions. [21] [22]
Side effects of CICs, besides menstrual bleeding changes, are minimal. [26] The most prominent side effects of CICs are menstrual irregularities during the first 3 to 6 months of use. [1] Dysmenorrhea has been reported in 30 to 65% of women. [26] Other side effects include breast tenderness/pain, headache, and libido changes. [26]
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