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Thomas J Kuehl - One of the best experts on this subject based on the ideXlab platform.
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frequency and management of Breakthrough Bleeding with continuous use of the transvaginal contraceptive ring a randomized controlled trial
Obstetrics & Gynecology, 2008Co-Authors: Patricia J Sulak, Virginia J Smith, Andrea Coffee, Iris Witt, Alicia L Kuehl, Thomas J KuehlAbstract:OBJECTIVE: To assess Bleeding patterns with continuous use of the transvaginal contraceptive ring. METHODS: We did a prospective analysis of daily menstrual flow during a 21/7 cycle followed by 6 months of continuous use and institution of a randomized protocol to manage Breakthrough Bleeding/spotting. Seventy-four women completed the baseline 21/7 phase and were randomized equally into two groups during the continuous phase. Group 1 was instructed to replace the ring monthly on the same calendar day with no ring-free days. Group 2 was instructed to use the same process but if Breakthrough Bleeding/spotting occurred for 5 days or more they were to remove the ring for 4 days store it and then reinsert that ring. RESULTS: Sixty-five women completed the continuous phase with reduced average flow scores in the continuous phase compared with the 21/7 phase (P<.02). Most patients had no to minimal Bleeding during continuous use with group 2 experiencing a statistically greater percentage of days without Breakthrough Bleeding or spotting (95%) compared with group 1 (89%) (P=.016). Instituting a 4-day hormone-free interval was more (P<.001) effective in resolving Breakthrough Bleeding/spotting than continuing ring use. CONCLUSION: A reduction in Bleeding occurred during continuous use with replacement of the transvaginal ring compared with baseline 21/7 use. Continuous vaginal ring use resulted in an acceptable Bleeding profile in most patients reduction in flow reduction in pelvic pain and a high continuation rate.
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Frequency and management of Breakthrough Bleeding with continuous use of the transvaginal contraceptive ring: a randomized controlled trial.
Obstetrics & Gynecology, 2008Co-Authors: Patricia J Sulak, Virginia J Smith, Andrea Coffee, Iris Witt, Alicia L Kuehl, Thomas J KuehlAbstract:OBJECTIVE: To assess Bleeding patterns with continuous use of the transvaginal contraceptive ring. METHODS: We did a prospective analysis of daily menstrual flow during a 21/7 cycle followed by 6 months of continuous use and institution of a randomized protocol to manage Breakthrough Bleeding/spotting. Seventy-four women completed the baseline 21/7 phase and were randomized equally into two groups during the continuous phase. Group 1 was instructed to replace the ring monthly on the same calendar day with no ring-free days. Group 2 was instructed to use the same process but if Breakthrough Bleeding/spotting occurred for 5 days or more they were to remove the ring for 4 days store it and then reinsert that ring. RESULTS: Sixty-five women completed the continuous phase with reduced average flow scores in the continuous phase compared with the 21/7 phase (P
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prospective analysis of occurrence and management of Breakthrough Bleeding during an extended oral contraceptive regimen
American Journal of Obstetrics and Gynecology, 2006Co-Authors: Patricia J Sulak, Andrea Coffee, Thomas J Kuehl, Sherilyn WillisAbstract:Objective The purpose of this study was to assess the Bleeding patterns of an extended oral contraceptive (OC) regimen and management of Breakthrough Bleeding/Breakthrough spotting (BTB/BTS). Study design This was a single-center prospective analysis of self-rated menstrual flow during a 21/7-day versus a 168-day extended regimen of on OC containing 3 mg of drosperinone and 30 mcg of ethinyl estradiol (DRSP/EE) with institution of a randomized protocol to manage BTB/BTS. Results Of the 111 patients initiating the extended OC regimen, 102 (92%) completed the 168-day regimen. Subjects having a heavier daily flow rating during the 21/7-day pre-extension cycle had greater daily flow ratings ( P P = .07) than subjects with lighter daily flow ratings. If BTB/BTS of at least 7 consecutive days occurred, patients were randomized to taking a 3-day hormone free interval (HFI) versus continuing active pills. Instituting a 3-day HFI was significantly more effective in resolving BTB/BTS than continuing active pills ( P P = .53). Conclusion A 168-day extended regimen of DRSP/EE had an acceptable Bleeding profile with a high continuation rate. Bleeding during the extended cycle was effectively managed with institution of a 3-day HFI.
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outcomes of extended oral contraceptive regimens with a shortened hormone free interval to manage Breakthrough Bleeding
Contraception, 2004Co-Authors: Patricia J Sulak, Andrea Coffee, Jenny Carl, Isai Gopalakrishnan, Thomas J KuehlAbstract:Abstract Objective To evaluate in a clinical practice setting the acceptance, continuation and variability of extending the active interval of oral contraceptives (OCs) with introduction of a shortened hormone-free interval (HFI) to manage Breakthrough Bleeding. Methods A retrospective review was undertaken of patients seen by one obstetrician/gynecologist and counseled on extending the active interval of OCs with a shortened HFI of 3–4 days to manage Bleeding. Electronic medical records were searched for the phrase “extending the number of active pills” for patients counseled between January 1, 2000, and January 31, 2003, with follow-up through January 31, 2004. A structured query of each patient's initial and follow-up records was performed. Results The 220 patients counseled on the extended regimen were 14–52 years of age (mean 36.4, SD 9.3 years). At initial counseling before extending, the majority of patients cited more than one reason for using OCs in the standard fashion with 59% using OCs for noncontraceptive reasons. Reasons for extending the active interval of OCs included premenstrual symptoms (45%), dysmenorrhea/pelvic pain (40%), heavy withdrawal Bleeding (36%), menstrual associated headaches (35%), convenience (13%), acne associated with menses (10%) and other (15%). Of the 181 patients with follow-up data, 174 (96%) attempted an extended regimen with 121 (67%) continuing to do so at last follow-up. Follow-up intervals ranged from 0.3 to 3.8 years (mean 1.6 years). Using Kaplan–Meier product limit survival analysis, 60% of patients continued using extended patterns of OCs for more than 2 years. For 121 currently extending, the HFI varied from 0 to 7 days with 88% utilizing a 0 to 4 day HFI. Conclusions Sixty percent of patients offered extending the active interval and shortening the HFI of OCs initiate and continue this pattern for more than 2 years without serious sequelae or pregnancy while individually directing both the number of days of continuous pills and the length of the HFI.
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original research article outcomes of extended oral contraceptive regimens with a shortened hormone free interval to manage Breakthrough Bleeding
2004Co-Authors: Patricia J Sulak, Jenny Carl, Isai Gopalakrishnan, Andrea Coffee, Thomas J KuehlAbstract:Objective: To evaluate in a clinical practice setting the acceptance, continuation and variability of extending the active interval of oral contraceptives (OCs) with introduction of a shortened hormone-free interval (HFI) to manage Breakthrough Bleeding. Methods: A retrospective review was undertaken of patients seen by one obstetrician/gynecologist and counseled on extending the active interval of OCs with a shortened HFI of 3– 4 days to manage Bleeding. Electronic medical records were searched for the phrase “extending the number of active pills” for patients counseled between January 1, 2000, and January 31, 2003, with follow-up through January 31, 2004. A structured query of each patient’s initial and follow-up records was performed. Results: The 220 patients counseled on the extended regimen were 14 –52 years of age (mean 36.4, SD 9.3 years). At initial counseling before extending, the majority of patients cited more than one reason for using OCs in the standard fashion with 59% using OCs for noncontraceptive reasons. Reasons for extending the active interval of OCs included premenstrual symptoms (45%), dysmenorrhea/pelvic pain (40%), heavy withdrawal Bleeding (36%), menstrual associated headaches (35%), convenience (13%), acne associated with menses (10%) and other (15%). Of the 181 patients with follow-up data, 174 (96%) attempted an extended regimen with 121 (67%) continuing to do so at last follow-up. Follow-up intervals ranged from 0.3 to 3.8 years (mean 1.6 years). Using Kaplan–Meier product limit survival analysis, 60% of patients continued using extended patterns of OCs for more than 2 years. For 121 currently extending, the HFI varied from 0 to 7 days with 88% utilizin ga0t o 4d ayHFI. Conclusions: Sixty percent of patients offered extending the active interval and shortening the HFI of OCs initiate and continue this pattern for more than 2 years without serious sequelae or pregnancy while individually directing both the number of days of continuous pills and the length of the HFI. © 2004 Elsevier Inc. All rights reserved.
Patricia J Sulak - One of the best experts on this subject based on the ideXlab platform.
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frequency and management of Breakthrough Bleeding with continuous use of the transvaginal contraceptive ring a randomized controlled trial
Obstetrics & Gynecology, 2008Co-Authors: Patricia J Sulak, Virginia J Smith, Andrea Coffee, Iris Witt, Alicia L Kuehl, Thomas J KuehlAbstract:OBJECTIVE: To assess Bleeding patterns with continuous use of the transvaginal contraceptive ring. METHODS: We did a prospective analysis of daily menstrual flow during a 21/7 cycle followed by 6 months of continuous use and institution of a randomized protocol to manage Breakthrough Bleeding/spotting. Seventy-four women completed the baseline 21/7 phase and were randomized equally into two groups during the continuous phase. Group 1 was instructed to replace the ring monthly on the same calendar day with no ring-free days. Group 2 was instructed to use the same process but if Breakthrough Bleeding/spotting occurred for 5 days or more they were to remove the ring for 4 days store it and then reinsert that ring. RESULTS: Sixty-five women completed the continuous phase with reduced average flow scores in the continuous phase compared with the 21/7 phase (P<.02). Most patients had no to minimal Bleeding during continuous use with group 2 experiencing a statistically greater percentage of days without Breakthrough Bleeding or spotting (95%) compared with group 1 (89%) (P=.016). Instituting a 4-day hormone-free interval was more (P<.001) effective in resolving Breakthrough Bleeding/spotting than continuing ring use. CONCLUSION: A reduction in Bleeding occurred during continuous use with replacement of the transvaginal ring compared with baseline 21/7 use. Continuous vaginal ring use resulted in an acceptable Bleeding profile in most patients reduction in flow reduction in pelvic pain and a high continuation rate.
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Frequency and management of Breakthrough Bleeding with continuous use of the transvaginal contraceptive ring: a randomized controlled trial.
Obstetrics & Gynecology, 2008Co-Authors: Patricia J Sulak, Virginia J Smith, Andrea Coffee, Iris Witt, Alicia L Kuehl, Thomas J KuehlAbstract:OBJECTIVE: To assess Bleeding patterns with continuous use of the transvaginal contraceptive ring. METHODS: We did a prospective analysis of daily menstrual flow during a 21/7 cycle followed by 6 months of continuous use and institution of a randomized protocol to manage Breakthrough Bleeding/spotting. Seventy-four women completed the baseline 21/7 phase and were randomized equally into two groups during the continuous phase. Group 1 was instructed to replace the ring monthly on the same calendar day with no ring-free days. Group 2 was instructed to use the same process but if Breakthrough Bleeding/spotting occurred for 5 days or more they were to remove the ring for 4 days store it and then reinsert that ring. RESULTS: Sixty-five women completed the continuous phase with reduced average flow scores in the continuous phase compared with the 21/7 phase (P
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prospective analysis of occurrence and management of Breakthrough Bleeding during an extended oral contraceptive regimen
American Journal of Obstetrics and Gynecology, 2006Co-Authors: Patricia J Sulak, Andrea Coffee, Thomas J Kuehl, Sherilyn WillisAbstract:Objective The purpose of this study was to assess the Bleeding patterns of an extended oral contraceptive (OC) regimen and management of Breakthrough Bleeding/Breakthrough spotting (BTB/BTS). Study design This was a single-center prospective analysis of self-rated menstrual flow during a 21/7-day versus a 168-day extended regimen of on OC containing 3 mg of drosperinone and 30 mcg of ethinyl estradiol (DRSP/EE) with institution of a randomized protocol to manage BTB/BTS. Results Of the 111 patients initiating the extended OC regimen, 102 (92%) completed the 168-day regimen. Subjects having a heavier daily flow rating during the 21/7-day pre-extension cycle had greater daily flow ratings ( P P = .07) than subjects with lighter daily flow ratings. If BTB/BTS of at least 7 consecutive days occurred, patients were randomized to taking a 3-day hormone free interval (HFI) versus continuing active pills. Instituting a 3-day HFI was significantly more effective in resolving BTB/BTS than continuing active pills ( P P = .53). Conclusion A 168-day extended regimen of DRSP/EE had an acceptable Bleeding profile with a high continuation rate. Bleeding during the extended cycle was effectively managed with institution of a 3-day HFI.
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outcomes of extended oral contraceptive regimens with a shortened hormone free interval to manage Breakthrough Bleeding
Contraception, 2004Co-Authors: Patricia J Sulak, Andrea Coffee, Jenny Carl, Isai Gopalakrishnan, Thomas J KuehlAbstract:Abstract Objective To evaluate in a clinical practice setting the acceptance, continuation and variability of extending the active interval of oral contraceptives (OCs) with introduction of a shortened hormone-free interval (HFI) to manage Breakthrough Bleeding. Methods A retrospective review was undertaken of patients seen by one obstetrician/gynecologist and counseled on extending the active interval of OCs with a shortened HFI of 3–4 days to manage Bleeding. Electronic medical records were searched for the phrase “extending the number of active pills” for patients counseled between January 1, 2000, and January 31, 2003, with follow-up through January 31, 2004. A structured query of each patient's initial and follow-up records was performed. Results The 220 patients counseled on the extended regimen were 14–52 years of age (mean 36.4, SD 9.3 years). At initial counseling before extending, the majority of patients cited more than one reason for using OCs in the standard fashion with 59% using OCs for noncontraceptive reasons. Reasons for extending the active interval of OCs included premenstrual symptoms (45%), dysmenorrhea/pelvic pain (40%), heavy withdrawal Bleeding (36%), menstrual associated headaches (35%), convenience (13%), acne associated with menses (10%) and other (15%). Of the 181 patients with follow-up data, 174 (96%) attempted an extended regimen with 121 (67%) continuing to do so at last follow-up. Follow-up intervals ranged from 0.3 to 3.8 years (mean 1.6 years). Using Kaplan–Meier product limit survival analysis, 60% of patients continued using extended patterns of OCs for more than 2 years. For 121 currently extending, the HFI varied from 0 to 7 days with 88% utilizing a 0 to 4 day HFI. Conclusions Sixty percent of patients offered extending the active interval and shortening the HFI of OCs initiate and continue this pattern for more than 2 years without serious sequelae or pregnancy while individually directing both the number of days of continuous pills and the length of the HFI.
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original research article outcomes of extended oral contraceptive regimens with a shortened hormone free interval to manage Breakthrough Bleeding
2004Co-Authors: Patricia J Sulak, Jenny Carl, Isai Gopalakrishnan, Andrea Coffee, Thomas J KuehlAbstract:Objective: To evaluate in a clinical practice setting the acceptance, continuation and variability of extending the active interval of oral contraceptives (OCs) with introduction of a shortened hormone-free interval (HFI) to manage Breakthrough Bleeding. Methods: A retrospective review was undertaken of patients seen by one obstetrician/gynecologist and counseled on extending the active interval of OCs with a shortened HFI of 3– 4 days to manage Bleeding. Electronic medical records were searched for the phrase “extending the number of active pills” for patients counseled between January 1, 2000, and January 31, 2003, with follow-up through January 31, 2004. A structured query of each patient’s initial and follow-up records was performed. Results: The 220 patients counseled on the extended regimen were 14 –52 years of age (mean 36.4, SD 9.3 years). At initial counseling before extending, the majority of patients cited more than one reason for using OCs in the standard fashion with 59% using OCs for noncontraceptive reasons. Reasons for extending the active interval of OCs included premenstrual symptoms (45%), dysmenorrhea/pelvic pain (40%), heavy withdrawal Bleeding (36%), menstrual associated headaches (35%), convenience (13%), acne associated with menses (10%) and other (15%). Of the 181 patients with follow-up data, 174 (96%) attempted an extended regimen with 121 (67%) continuing to do so at last follow-up. Follow-up intervals ranged from 0.3 to 3.8 years (mean 1.6 years). Using Kaplan–Meier product limit survival analysis, 60% of patients continued using extended patterns of OCs for more than 2 years. For 121 currently extending, the HFI varied from 0 to 7 days with 88% utilizin ga0t o 4d ayHFI. Conclusions: Sixty percent of patients offered extending the active interval and shortening the HFI of OCs initiate and continue this pattern for more than 2 years without serious sequelae or pregnancy while individually directing both the number of days of continuous pills and the length of the HFI. © 2004 Elsevier Inc. All rights reserved.
Andrea Coffee - One of the best experts on this subject based on the ideXlab platform.
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frequency and management of Breakthrough Bleeding with continuous use of the transvaginal contraceptive ring a randomized controlled trial
Obstetrics & Gynecology, 2008Co-Authors: Patricia J Sulak, Virginia J Smith, Andrea Coffee, Iris Witt, Alicia L Kuehl, Thomas J KuehlAbstract:OBJECTIVE: To assess Bleeding patterns with continuous use of the transvaginal contraceptive ring. METHODS: We did a prospective analysis of daily menstrual flow during a 21/7 cycle followed by 6 months of continuous use and institution of a randomized protocol to manage Breakthrough Bleeding/spotting. Seventy-four women completed the baseline 21/7 phase and were randomized equally into two groups during the continuous phase. Group 1 was instructed to replace the ring monthly on the same calendar day with no ring-free days. Group 2 was instructed to use the same process but if Breakthrough Bleeding/spotting occurred for 5 days or more they were to remove the ring for 4 days store it and then reinsert that ring. RESULTS: Sixty-five women completed the continuous phase with reduced average flow scores in the continuous phase compared with the 21/7 phase (P<.02). Most patients had no to minimal Bleeding during continuous use with group 2 experiencing a statistically greater percentage of days without Breakthrough Bleeding or spotting (95%) compared with group 1 (89%) (P=.016). Instituting a 4-day hormone-free interval was more (P<.001) effective in resolving Breakthrough Bleeding/spotting than continuing ring use. CONCLUSION: A reduction in Bleeding occurred during continuous use with replacement of the transvaginal ring compared with baseline 21/7 use. Continuous vaginal ring use resulted in an acceptable Bleeding profile in most patients reduction in flow reduction in pelvic pain and a high continuation rate.
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Frequency and management of Breakthrough Bleeding with continuous use of the transvaginal contraceptive ring: a randomized controlled trial.
Obstetrics & Gynecology, 2008Co-Authors: Patricia J Sulak, Virginia J Smith, Andrea Coffee, Iris Witt, Alicia L Kuehl, Thomas J KuehlAbstract:OBJECTIVE: To assess Bleeding patterns with continuous use of the transvaginal contraceptive ring. METHODS: We did a prospective analysis of daily menstrual flow during a 21/7 cycle followed by 6 months of continuous use and institution of a randomized protocol to manage Breakthrough Bleeding/spotting. Seventy-four women completed the baseline 21/7 phase and were randomized equally into two groups during the continuous phase. Group 1 was instructed to replace the ring monthly on the same calendar day with no ring-free days. Group 2 was instructed to use the same process but if Breakthrough Bleeding/spotting occurred for 5 days or more they were to remove the ring for 4 days store it and then reinsert that ring. RESULTS: Sixty-five women completed the continuous phase with reduced average flow scores in the continuous phase compared with the 21/7 phase (P
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prospective analysis of occurrence and management of Breakthrough Bleeding during an extended oral contraceptive regimen
American Journal of Obstetrics and Gynecology, 2006Co-Authors: Patricia J Sulak, Andrea Coffee, Thomas J Kuehl, Sherilyn WillisAbstract:Objective The purpose of this study was to assess the Bleeding patterns of an extended oral contraceptive (OC) regimen and management of Breakthrough Bleeding/Breakthrough spotting (BTB/BTS). Study design This was a single-center prospective analysis of self-rated menstrual flow during a 21/7-day versus a 168-day extended regimen of on OC containing 3 mg of drosperinone and 30 mcg of ethinyl estradiol (DRSP/EE) with institution of a randomized protocol to manage BTB/BTS. Results Of the 111 patients initiating the extended OC regimen, 102 (92%) completed the 168-day regimen. Subjects having a heavier daily flow rating during the 21/7-day pre-extension cycle had greater daily flow ratings ( P P = .07) than subjects with lighter daily flow ratings. If BTB/BTS of at least 7 consecutive days occurred, patients were randomized to taking a 3-day hormone free interval (HFI) versus continuing active pills. Instituting a 3-day HFI was significantly more effective in resolving BTB/BTS than continuing active pills ( P P = .53). Conclusion A 168-day extended regimen of DRSP/EE had an acceptable Bleeding profile with a high continuation rate. Bleeding during the extended cycle was effectively managed with institution of a 3-day HFI.
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outcomes of extended oral contraceptive regimens with a shortened hormone free interval to manage Breakthrough Bleeding
Contraception, 2004Co-Authors: Patricia J Sulak, Andrea Coffee, Jenny Carl, Isai Gopalakrishnan, Thomas J KuehlAbstract:Abstract Objective To evaluate in a clinical practice setting the acceptance, continuation and variability of extending the active interval of oral contraceptives (OCs) with introduction of a shortened hormone-free interval (HFI) to manage Breakthrough Bleeding. Methods A retrospective review was undertaken of patients seen by one obstetrician/gynecologist and counseled on extending the active interval of OCs with a shortened HFI of 3–4 days to manage Bleeding. Electronic medical records were searched for the phrase “extending the number of active pills” for patients counseled between January 1, 2000, and January 31, 2003, with follow-up through January 31, 2004. A structured query of each patient's initial and follow-up records was performed. Results The 220 patients counseled on the extended regimen were 14–52 years of age (mean 36.4, SD 9.3 years). At initial counseling before extending, the majority of patients cited more than one reason for using OCs in the standard fashion with 59% using OCs for noncontraceptive reasons. Reasons for extending the active interval of OCs included premenstrual symptoms (45%), dysmenorrhea/pelvic pain (40%), heavy withdrawal Bleeding (36%), menstrual associated headaches (35%), convenience (13%), acne associated with menses (10%) and other (15%). Of the 181 patients with follow-up data, 174 (96%) attempted an extended regimen with 121 (67%) continuing to do so at last follow-up. Follow-up intervals ranged from 0.3 to 3.8 years (mean 1.6 years). Using Kaplan–Meier product limit survival analysis, 60% of patients continued using extended patterns of OCs for more than 2 years. For 121 currently extending, the HFI varied from 0 to 7 days with 88% utilizing a 0 to 4 day HFI. Conclusions Sixty percent of patients offered extending the active interval and shortening the HFI of OCs initiate and continue this pattern for more than 2 years without serious sequelae or pregnancy while individually directing both the number of days of continuous pills and the length of the HFI.
Anne Marie Powell - One of the best experts on this subject based on the ideXlab platform.
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evaluation and therapy of Breakthrough Bleeding in women using a triphasic oral contraceptive
Fertility and Sterility, 1991Co-Authors: Robert F Casper, Anne Marie PowellAbstract:This study was designed to investigate the incidence and pattern of Breakthrough Bleeding (BTB) in 1,259 women who were prescribed for the first time a triphasic oral contraceptive (OC, 7-7-7) and to evaluate a hypothesis of management for BTB persisting after three cycles. The new users were compared with a control group of 696 women who had used various OCs for at least 6months. The incidence of BTB in the control group was 16.8% and in the new users was 24.9%, 17.5%, and 15.3% in the first 3months, respectively. Breakthrough Bleeding occurred late in the 7-7-7 package in 58% and early or midway through the package in 17% and 25%, respectively. We hypothesized that late-package BTB would improve if the patient was switched to a monophasic pill similar to the relatively estrogenic formulation of the beginning of the package and vice versa for early or midpackage BTB. Seventy women with BTB at 3months were randomly given 0.5/35 or 1/35 for a further 3months. Breakthrough Bleeding was more likely ( P
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Gynecology-endocrinologyEvaluation and therapy of Breakthrough Bleeding in women using a triphasic oral contraceptive*
Fertility and Sterility, 1991Co-Authors: Robert F Casper, Anne Marie PowellAbstract:This study was designed to investigate the incidence and pattern of Breakthrough Bleeding (BTB) in 1,259 women who were prescribed for the first time a triphasic oral contraceptive (OC, 7-7-7) and to evaluate a hypothesis of management for BTB persisting after three cycles. The new users were compared with a control group of 696 women who had used various OCs for at least 6months. The incidence of BTB in the control group was 16.8% and in the new users was 24.9%, 17.5%, and 15.3% in the first 3months, respectively. Breakthrough Bleeding occurred late in the 7-7-7 package in 58% and early or midway through the package in 17% and 25%, respectively. We hypothesized that late-package BTB would improve if the patient was switched to a monophasic pill similar to the relatively estrogenic formulation of the beginning of the package and vice versa for early or midpackage BTB. Seventy women with BTB at 3months were randomly given 0.5/35 or 1/35 for a further 3months. Breakthrough Bleeding was more likely ( P
Mauriceandre Recanati - One of the best experts on this subject based on the ideXlab platform.
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norethindrone is superior to combined oral contraceptive pills in short term delay of menses and onset of Breakthrough Bleeding a randomized trial
BMC Women's Health, 2019Co-Authors: Joshua Dean, Katherine J Kramer, Fauzia Akbary, Shaunte Wade, Maik Huttemann, Jay M Berman, Mauriceandre RecanatiAbstract:To determine whether oral norethindrone acetate is superior to combined oral contraceptives (OCP) in delaying menstruation and preventing Breakthrough Bleeding when started late in the cycle. This article comprises of a case control study followed by a pilot randomized controlled study. In the first study, four women who presented late in their cycle and desired avoiding vaginal Bleeding within 10 days before a wedding were started on norethindrone 5 mg three times daily and compared to age matched controls started on OCPs. Subsequently, a randomized controlled pilot study (n = 50) comparing OCPs to norethindrone for the retiming of menses was conducted. Percentage of women reporting spotting were compared with level of statistical significance set at p < 0.05. Of the norethindrone treated group, only 2 women (8%) reported spotting compared with 10 women (43%) in the control group (p < 0.01). Norethindrone recipients experienced significant weight gain, which resolved after cessation of therapy and had heavier withdrawal bleed (p < 0.04) when compared to controls. Patient satisfaction was significantly higher in the norethindrone group, with 80% willing to choose this method again. Time to conceive was significantly shorter in the norethindrone group (p < 0.03). Norethindrone, begun on or before cycle day 12, is superior for women who desire to avoid Breakthrough Bleeding and maintain fertility when compared to OCPs. It is an ideal approach in patients presenting late in their cycle and who desire delaying menses as well as in circumstances when even minute amounts of Breakthrough Bleeding cannot be tolerated. Clinicaltrials.gov NCT03594604 , July 2018. Retrospectively registered.
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Norethindrone is superior to combined oral contraceptive pills in short-term delay of menses and onset of Breakthrough Bleeding: a randomized trial
BMC Women's Health, 2019Co-Authors: Joshua Dean, Katherine J Kramer, Fauzia Akbary, Shaunte Wade, Maik Huttemann, Jay M Berman, Mauriceandre RecanatiAbstract:To determine whether oral norethindrone acetate is superior to combined oral contraceptives (OCP) in delaying menstruation and preventing Breakthrough Bleeding when started late in the cycle. This article comprises of a case control study followed by a pilot randomized controlled study. In the first study, four women who presented late in their cycle and desired avoiding vaginal Bleeding within 10 days before a wedding were started on norethindrone 5 mg three times daily and compared to age matched controls started on OCPs. Subsequently, a randomized controlled pilot study (n = 50) comparing OCPs to norethindrone for the retiming of menses was conducted. Percentage of women reporting spotting were compared with level of statistical significance set at p
