Continuous compared with cyclic oral contraceptives for the treatment of primary dysmenorrhea: A randomized controlled trial

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Abstract

Objective: To estimate whether continuous oral contraceptive pills (OCPs) will result in more pain relief in primary dysmenorrhea patients than cyclic OCPs, which induce withdrawal bleeding with associated pain and symptoms. Methods: We conducted a double-blind, randomized, controlled trial comparing continuous to a cyclic 21-7 OCP regimen (gestodene 0.075 mg and ethinyl estradiol 20 microgram) for 6 months in 38 primary dysmenorrhea patients. The primary outcome was the difference in subjective perception of pain as measured by the visual analog scale over a period of 6 months. Results: Twenty-nine patients completed the study. In both groups, pain reduction measured by visual analog scale declined over time and was significant at 6 months compared with baseline, with no difference between groups. Continuous regimen was superior to cyclic regimen after 1 month (mean difference-27.3, 95% confidence interval [CI]-40.5 to-14.2; P<.001) and 3 months (mean difference-17.8, 95% CI-33.4 to-2.1; P=.03) of treatment. Secondary outcomes noted no difference between groups in terms of menstrual distress as measured by the Moos Menstrual Distress Questionnaire. After 6 months, there was an increase in weight and a decrease in systolic blood pressure in the continuous group compared with the cyclic group. Conclusion: Both regimens of OCPs are effective in the treatment of primary dysmenorrhea. Continuous OCPs outperform cyclic OCPs in the short term, but this difference is lost after 6 months. Clinical Trial Registration: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00517556.

Original languageEnglish (US)
Pages (from-to)1143-1150
Number of pages8
JournalObstetrics and gynecology
Volume119
Issue number6
DOIs
StatePublished - Jun 1 2012

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Dysmenorrhea
Oral Contraceptives
Randomized Controlled Trials
Visual Analog Scale
Pain
Therapeutics
Confidence Intervals
Blood Pressure
Pain Perception
Ethinyl Estradiol
Clinical Trials
Hemorrhage
Weights and Measures

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynecology

Cite this

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title = "Continuous compared with cyclic oral contraceptives for the treatment of primary dysmenorrhea: A randomized controlled trial",
abstract = "Objective: To estimate whether continuous oral contraceptive pills (OCPs) will result in more pain relief in primary dysmenorrhea patients than cyclic OCPs, which induce withdrawal bleeding with associated pain and symptoms. Methods: We conducted a double-blind, randomized, controlled trial comparing continuous to a cyclic 21-7 OCP regimen (gestodene 0.075 mg and ethinyl estradiol 20 microgram) for 6 months in 38 primary dysmenorrhea patients. The primary outcome was the difference in subjective perception of pain as measured by the visual analog scale over a period of 6 months. Results: Twenty-nine patients completed the study. In both groups, pain reduction measured by visual analog scale declined over time and was significant at 6 months compared with baseline, with no difference between groups. Continuous regimen was superior to cyclic regimen after 1 month (mean difference-27.3, 95{\%} confidence interval [CI]-40.5 to-14.2; P<.001) and 3 months (mean difference-17.8, 95{\%} CI-33.4 to-2.1; P=.03) of treatment. Secondary outcomes noted no difference between groups in terms of menstrual distress as measured by the Moos Menstrual Distress Questionnaire. After 6 months, there was an increase in weight and a decrease in systolic blood pressure in the continuous group compared with the cyclic group. Conclusion: Both regimens of OCPs are effective in the treatment of primary dysmenorrhea. Continuous OCPs outperform cyclic OCPs in the short term, but this difference is lost after 6 months. Clinical Trial Registration: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00517556.",
author = "Romana Dmitrovic and Kunselman, {Allen R.} and Legro, {Richard S.}",
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T1 - Continuous compared with cyclic oral contraceptives for the treatment of primary dysmenorrhea

T2 - A randomized controlled trial

AU - Dmitrovic, Romana

AU - Kunselman, Allen R.

AU - Legro, Richard S.

PY - 2012/6/1

Y1 - 2012/6/1

N2 - Objective: To estimate whether continuous oral contraceptive pills (OCPs) will result in more pain relief in primary dysmenorrhea patients than cyclic OCPs, which induce withdrawal bleeding with associated pain and symptoms. Methods: We conducted a double-blind, randomized, controlled trial comparing continuous to a cyclic 21-7 OCP regimen (gestodene 0.075 mg and ethinyl estradiol 20 microgram) for 6 months in 38 primary dysmenorrhea patients. The primary outcome was the difference in subjective perception of pain as measured by the visual analog scale over a period of 6 months. Results: Twenty-nine patients completed the study. In both groups, pain reduction measured by visual analog scale declined over time and was significant at 6 months compared with baseline, with no difference between groups. Continuous regimen was superior to cyclic regimen after 1 month (mean difference-27.3, 95% confidence interval [CI]-40.5 to-14.2; P<.001) and 3 months (mean difference-17.8, 95% CI-33.4 to-2.1; P=.03) of treatment. Secondary outcomes noted no difference between groups in terms of menstrual distress as measured by the Moos Menstrual Distress Questionnaire. After 6 months, there was an increase in weight and a decrease in systolic blood pressure in the continuous group compared with the cyclic group. Conclusion: Both regimens of OCPs are effective in the treatment of primary dysmenorrhea. Continuous OCPs outperform cyclic OCPs in the short term, but this difference is lost after 6 months. Clinical Trial Registration: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00517556.

AB - Objective: To estimate whether continuous oral contraceptive pills (OCPs) will result in more pain relief in primary dysmenorrhea patients than cyclic OCPs, which induce withdrawal bleeding with associated pain and symptoms. Methods: We conducted a double-blind, randomized, controlled trial comparing continuous to a cyclic 21-7 OCP regimen (gestodene 0.075 mg and ethinyl estradiol 20 microgram) for 6 months in 38 primary dysmenorrhea patients. The primary outcome was the difference in subjective perception of pain as measured by the visual analog scale over a period of 6 months. Results: Twenty-nine patients completed the study. In both groups, pain reduction measured by visual analog scale declined over time and was significant at 6 months compared with baseline, with no difference between groups. Continuous regimen was superior to cyclic regimen after 1 month (mean difference-27.3, 95% confidence interval [CI]-40.5 to-14.2; P<.001) and 3 months (mean difference-17.8, 95% CI-33.4 to-2.1; P=.03) of treatment. Secondary outcomes noted no difference between groups in terms of menstrual distress as measured by the Moos Menstrual Distress Questionnaire. After 6 months, there was an increase in weight and a decrease in systolic blood pressure in the continuous group compared with the cyclic group. Conclusion: Both regimens of OCPs are effective in the treatment of primary dysmenorrhea. Continuous OCPs outperform cyclic OCPs in the short term, but this difference is lost after 6 months. Clinical Trial Registration: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00517556.

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