Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-13T00:57:42.540Z Has data issue: false hasContentIssue false

Chapter 16 - Management of Issues Associated with Female Contraceptives

Bleeding

from Section 2A - Sexual and Reproductive Healthcare: Contraception

Published online by Cambridge University Press:  16 January 2024

By
Katarina Sedlecky  and
Johannes Bitzer
Edited by
Johannes Bitzer  and
Tahir A. Mahmood
Johannes Bitzer
Affiliation:
University Women's Hospital, Basel
Tahir A. Mahmood
Affiliation:
Victoria Hospital, Kirkcaldy
Get access

Summary

Unscheduled bleeding is common during hormonal contraception (HC) use. It increases the likelihood of poor adherence and premature discontinuation of the contraceptive method. In users of combined hormonal contraception (CHC) bleeding disturbances are more frequent in the first months, occurring in up to one third of women in the first cycle and decreasing afterwards to about 5% at the sixth month [1].

Type
Chapter
Information
Textbook of Contraception, Sexual and Reproductive Health , pp. 118 - 122
Publisher: Cambridge University Press
Print publication year: 2024

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bitzer, J, Simon, JA. Current issues and available options in combined hormonal contraception. Contraception. 2011;84(4):342–56.CrossRefGoogle ScholarPubMed
Sabatini, R, Cagiano, R. Comparison profiles of cycle control, side effects and sexual satisfaction of three hormonal contraceptives. Contraception. 2006;74(3):220–3.CrossRefGoogle ScholarPubMed
Yu, Q, Huang, Z, Ren, M et al. Contraceptive efficacy and safety of estradiol valerate/dienogest in a healthy female population: A multicenter, open-label, uncontrolled Phase III study. Int J Womens Health. 2018;10:257–66.CrossRefGoogle Scholar
Van Vliet, HA, Grimes, DA, Lopez, LM, Schulz, KF, Helmerhorst, FM. Triphasic versus monophasic oral contraceptives for contraception. Cochrane Database Syst Rev. 2011;11:CD003553.Google Scholar
Lawrie, TA, Helmerhorst, FM, Maitra, NK et al. Types of progestogens in combined oral contraception: Effectiveness and side-effects. Cochrane Database Syst Rev. 2011;5:CD004861.Google Scholar
Lopez, LM, Grimes, DA, Gallo, MF, Stockton, LL, Schulz, KF. Skin patch and vaginal ring versus combined oral contraceptives for contraception. Cochrane Database Syst Rev. 2013;4:CD003552.Google Scholar
Palacios, S, Colli, E, Regidor, PA. A multicenter, double-blind, randomized trial on the bleeding profile of a drospirenone-only pill 4 mg over nine cycles in comparison with desogestrel 0.075 mg. Arch Gynecol Obstet. 2019;300(6):1805–12.CrossRefGoogle ScholarPubMed
ESHRE Capri Workshop Group. Ovarian and endometrial function during hormonal contraception. Hum Reprod. 2001;16(7):1527–35.Google Scholar
Diedrich, JT, Zhao, Q, Madden, T, Secura, GM, Peipert, JF. Three-year continuation of reversible contraception. Am J Obstet Gynecol. 2015;213(5):662.e1–8.CrossRefGoogle ScholarPubMed
Fruzzetti, F, Paoletti, AM, Fidecicchi, T et al. Contraception with estradiol valerate and dienogest: Adherence to the method. Open Access J Contracept. 2019;10:1–6.CrossRefGoogle ScholarPubMed
Zigler, RE, McNicholas, C. Unscheduled vaginal bleeding with progestin-only contraceptive use. Am J Obstet Gynecol. 2017;216(5):443–50.CrossRefGoogle ScholarPubMed
Vincent, AJ, Zhang, J, Ostör, A et al. Decreased tissue inhibitor of metalloproteinase in the endometrium of women using depot medroxyprogesterone acetate: A role for altered endometrial matrix metalloproteinase/tissue inhibitor of metalloproteinase balance in the pathogenesis of abnormal uterine bleeding? Hum Reprod. 2002;17(5):1189–98.CrossRefGoogle ScholarPubMed
Hickey, M, Crewe, J, Mahoney, LA et al. Mechanisms of irregular bleeding with hormone therapy: The role of matrix metalloproteinases and their tissue inhibitors. J Clin Endocrinol Metab. 2006;91(8):3189–98.CrossRefGoogle ScholarPubMed
Foran, T. The management of irregular bleeding in women using contraception. Aust Fam Physician. 2017;46(10):717–20.Google ScholarPubMed
Duijkers, I, Klipping, C, Heger-Mahn, D et al. Phase II dose-finding study on ovulation inhibition and cycle control associated with the use of contraceptive vaginal rings containing 17β-estradiol and the progestagens etonogestrel or nomegestrol acetate compared to NuvaRing. Eur J Contracept Reprod Health Care. 2018;23(4):245–54.CrossRefGoogle ScholarPubMed
Virro, JJ, Besinque, K, Carney, CE et al. Long-lasting, patient-controlled, procedure-free contraception: A review of Annovera with a pharmacist perspective. Pharmacy (Basel). 2020;8(3):156–61.Google ScholarPubMed
Kaneshiro, B, Edelman, A, Carlson, NE et al. A randomized controlled trial of subantimicrobial-dose doxycycline to prevent unscheduled bleeding with continuous oral contraceptive pill use. Contraception. 2012;85(4):351–8.CrossRefGoogle ScholarPubMed
Madden, T, Proehl, S, Allsworth, JE, Secura, GM, Peipert, JF. Naproxen or estradiol for bleeding and spotting with the levonorgestrel intrauterine system: A randomized controlled trial. Am J Obstet Gynecol. 2012;206(2):129.e1–8.CrossRefGoogle ScholarPubMed
Weisberg, E, Hickey, M, Palmer, D et al. A pilot study to assess the effect of three short-term treatments on frequent and/or prolonged bleeding compared to placebo in women using Implanon. Hum Reprod. 2006;21(1):295–302.CrossRefGoogle ScholarPubMed
Sørdal, T, Inki, P, Draeby, J, O’Flynn, M, Schmelter, T. Management of initial bleeding or spotting after levonorgestrel-releasing intrauterine system placement: A randomized controlled trial. Obstet Gynecol. 2013;121(5):934–41.CrossRefGoogle ScholarPubMed
Papaikonomou, K, Kopp Kallner, H, Söderdahl, F, Gemzell-Danielsson, K. Mifepristone treatment prior to insertion of a levonorgestrel releasing intrauterine system for improved bleeding control: A randomized controlled trial. Hum Reprod. 2018;33(11):2002–9.CrossRefGoogle ScholarPubMed
Cohen, MA, Simmons, KB, Edelman, AB, Jensen, JT. Tamoxifen for the prevention of unscheduled bleeding in new users of the levonorgestrel 52-mg intrauterine system: A randomized controlled trial. Contraception. 2019;100(5):391–6.CrossRefGoogle ScholarPubMed
Simmons, KB, Edelman, AB, Fu, R, Jensen, JT. Tamoxifen for the treatment of breakthrough bleeding with the etonogestrel implant: A randomized controlled trial. Contraception. 2017;95(2):198–204.CrossRefGoogle ScholarPubMed
Zigler, RE, Madden, T, Ashby, C, Wan, L, McNicholas, C. Ulipristal acetate for unscheduled bleeding in etonogestrel implant users: A randomized controlled trial. Obstet Gynecol. 2018;132(4):888–94.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×