Long-cycle treatment with oral contraceptives

  • I. W
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The conventional regimen of oral contraceptive (OC) use mimics the natural cycles by causing regular withdrawal bleeding, which can be avoided by omission of the hormone-free interval of 7 days. Consequently, long-cycle regimens with continuous administration of OCs for 3 or 6 months followed by a hormone-free interval of 7 days may reduce the frequency of menstruations and cycle-dependent complaints. Surveys have revealed that, despite a higher rate of irregular bleeding, the majority of women prefer the long-cycle regimen to the conventional OC regimen with regular bleeds every 4 weeks because it may improve quality of life. As this regimen increases the contraceptive efficacy to a large degree, continuous treatment with OCs may prevent unintended pregnancies in women who miss a pill or are concomitantly treated with drugs that are able to impair the efficacy of OCs. Postponement of withdrawal bleeding may also reduce or prevent menses-associated disorders such as hypermenorrhoea and dysmenorrhoea, and have beneficial effects in patients with haemorrhagic diathesis, endometriosis, uterine leiomyoma and polycystic ovary syndrome. Continuous use of OCs prevents the cyclic fluctuations of serum levels of ethinylestradiol and progestogen and, hence, the cyclic variations of metabolic serum parameters. Although the long-cycle regimen is initially associated with an elevated rate of irregular bleeding, the total number of bleeding days that require sanitary product protection is lower than during conventional OC treatment. Many physicians tend to prescribe extended OC cycles for postponement of menstruation or reduction of frequency of regular bleeding. This review summarises and examines the available data on OC long-cycle regimens. The data suggest that the rate of treatment-related side effects with OCs according to the long-cycle regimen is similar to that of conventional OC regimens. However, clinical trials are necessary to assess the impact of long-term OC long cycles on safety, particularly the risk of cancer and cardiovascular disease, and fertility after discontinuation of treatment.

Author-supplied keywords

  • *bleeding tendency/dm [Disease Management]
  • *bleeding tendency/dt [Drug Therapy]
  • *endometriosis/dm [Disease Management]
  • *endometriosis/dt [Drug Therapy]
  • *oral contraceptive agent/ae [Adverse Drug Reactio
  • *oral contraceptive agent/ct [Clinical Trial]
  • *oral contraceptive agent/dt [Drug Therapy]
  • *oral contraceptive agent/pd [Pharmacology]
  • *oral contraceptive agent/pe [Pharmacoeconomics]
  • *oral contraceptive agent/pk [Pharmacokinetics]
  • *oral contraceptive agent/po [Oral Drug Administra
  • *ovary polycystic disease/dm [Disease Management]
  • *ovary polycystic disease/dt [Drug Therapy]
  • *uterus myoma/dm [Disease Management]
  • *uterus myoma/dt [Drug Therapy]
  • acne/si [Side Effect]
  • antithrombin III/ec [Endogenous Compound]
  • apolipoprotein A1/ec [Endogenous Compound]
  • apolipoprotein B/ec [Endogenous Compound]
  • blood clotting factor 7/ec [Endogenous Compound]
  • body weight
  • breast tenderness/si [Side Effect]
  • cancer risk
  • cholesterol/ec [Endogenous Compound]
  • climacterium
  • clinical trial
  • colon cancer
  • cost effectiveness analysis
  • cyproterone acetate/ae [Adverse Drug Reaction]
  • cyproterone acetate/ct [Clinical Trial]
  • cyproterone acetate/dt [Drug Therapy]
  • cyproterone acetate/pd [Pharmacology]
  • cyproterone acetate/pe [Pharmacoeconomics]
  • cyproterone acetate/pk [Pharmacokinetics]
  • cyproterone acetate/po [Oral Drug Administration]
  • depression/si [Side Effect]
  • desogestrel/ae [Adverse Drug Reaction]
  • desogestrel/ct [Clinical Trial]
  • desogestrel/dt [Drug Therapy]
  • desogestrel/pd [Pharmacology]
  • desogestrel/pe [Pharmacoeconomics]
  • desogestrel/pk [Pharmacokinetics]
  • dienogest/ae [Adverse Drug Reaction]
  • dienogest/ct [Clinical Trial]
  • dienogest/dt [Drug Therapy]
  • dienogest/pd [Pharmacology]
  • dienogest/pe [Pharmacoeconomics]
  • dienogest/pk [Pharmacokinetics]
  • dienogest/po [Oral Drug Administration]
  • dizziness/co [Complication]
  • dizziness/si [Side Effect]
  • drug cost
  • drug efficacy
  • drug indication
  • drug metabolism
  • drug safety
  • endometrium cancer
  • estradiol/ec [Endogenous Compound]
  • ethinylestradiol/ae [Adverse Drug Reaction]
  • ethinylestradiol/ct [Clinical Trial]
  • ethinylestradiol/dt [Drug Therapy]
  • ethinylestradiol/pd [Pharmacology]
  • ethinylestradiol/pe [Pharmacoeconomics]
  • ethinylestradiol/pk [Pharmacokinetics]
  • ethinylestradiol/po [Oral Drug Administration]
  • female fertility
  • fibrinogen/ec [Endogenous Compound]
  • follitropin/ec [Endogenous Compound]
  • gestodene/ae [Adverse Drug Reaction]
  • gestodene/ct [Clinical Trial]
  • gestodene/dt [Drug Therapy]
  • gestodene/pd [Pharmacology]
  • gestodene/pe [Pharmacoeconomics]
  • gestodene/pk [Pharmacokinetics]
  • gestodene/po [Oral Drug Administration]
  • gonadorelin agonist/ae [Adverse Drug Reaction]
  • gonadorelin agonist/ct [Clinical Trial]
  • gonadorelin agonist/dt [Drug Therapy]
  • gonadorelin agonist/pd [Pharmacology]
  • gonadorelin agonist/pe [Pharmacoeconomics]
  • gonadorelin agonist/pk [Pharmacokinetics]
  • high density lipoprotein cholesterol/ec [Endogenou
  • hormonal therapy
  • human
  • levonorgestrel/ae [Adverse Drug Reaction]
  • levonorgestrel/ct [Clinical Trial]
  • levonorgestrel/dt [Drug Therapy]
  • levonorgestrel/pd [Pharmacology]
  • levonorgestrel/pe [Pharmacoeconomics]
  • levonorgestrel/pk [Pharmacokinetics]
  • levonorgestrel/po [Oral Drug Administration]
  • long term care
  • low density lipoprotein cholesterol/ec [Endogenous
  • luteinizing hormone/ec [Endogenous Compound]
  • lynestrenol/ae [Adverse Drug Reaction]
  • lynestrenol/ct [Clinical Trial]
  • lynestrenol/dt [Drug Therapy]
  • lynestrenol/pd [Pharmacology]
  • lynestrenol/pe [Pharmacoeconomics]
  • lynestrenol/pk [Pharmacokinetics]
  • lynestrenol/po [Oral Drug Administration]
  • nausea/si [Side Effect]
  • nervousness
  • plasminogen activator inhibitor/ec [Endogenous Com
  • prasterone sulfate/ec [Endogenous Compound]
  • protein C/ec [Endogenous Compound]
  • protein S/ec [Endogenous Compound]
  • review
  • serum globulin/ec [Endogenous Compound]
  • sex hormone binding globulin/ec [Endogenous Compou
  • side effect/si [Side Effect]
  • systematic review
  • testosterone/ec [Endogenous Compound]
  • tissue plasminogen activator/ec [Endogenous Compou
  • transcortin/ec [Endogenous Compound]
  • unindexed drug

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  • Wiegratz I.

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