Bleeding patterns in users of a continuous contraceptive combination
containing ethinyl-estradiol and gestodene
R.B. Machado, P. Fabrini, E.M.C. Maia, F.G. Tachotti, E.M.P. Pádua, A.M.
Department of Obstetrics and Gynecology, Faculty of Medicine, Jundiaí,
São Paulo, Brazil
Objective: The objective of this study was to evaluate bleeding
patterns during continuous use of a combined oral contraceptive pill containing
ethinyl-estradiol and gestodene.
Methods: Thirty-two patients with mean age of 25.0+3.7 years
were evaluated in an open, prospective, non-comparative study. Patients used the
contraceptive combination of ethinyl-estradiol 30 mcg and gestodene 75 mcg
continuously for six consecutive months. Any occasional bleeding was classified
as spotting, light, moderate or heavy bleeding. Spotting was defined as very
light bleeding when a change of sanitary protection was not required. The
occurrence of any bleeding outside the patient’s usual bleeding pattern was
defined as light, moderate or heavy bleeding based for comparison on the
parameters presented by the patient from previous menstrual cycles. For data
analysis, the 6-month duration of the study was divided into six periods of 28
days of continuous contraceptive use, referred to as Cycle 1 – Cycle 6. The
mean number of days of any kind of bleeding was calculated for each cycle.
Analysis of variance (ANOVA) was used in the statistical analysis to compare the
mean number of bleeding days in the six cycles studied.
Results: The majority of patients presented no bleeding during the
evaluation period. At the end of the sixth cycle of continuous use, 82% of
patients reported no bleeding. The most common type of bleeding was spotting,
reported by 41% of patients, most frequently during the third cycle of use. The
mean duration of spotting was 3.1+6.3 days (p=0.002 when compared to
Cycles 1, 4, 5 and 6). Overall bleeding rate was also greater in the third cycle
with a mean of 5.8+9 days (p=0.001 compared to Cycles 1, 5 and 6). After
the fourth cycle of use, there was a reduction in the overall bleeding rate and
an increase in the rate of amenorrhea.
Conclusion: The continuous use of an oral contraceptive containing
ethinyl-estradiol and gestodene was associated with an acceptable bleeding
pattern consisting principally of spotting. The rates of amenorrhea were high
after the fourth month of use.