The Debate regarding Continuous Use of Oral Contraceptives

Abstract

OBJECTIVE: To determine whether oral contraceptives (OCs) can be used safely in a continuous manner to prevent monthly withdrawal bleeding. DATA SOURCES: Search of MEDLINE (1966–2000), International Pharmaceutical Abstracts (1970–2000), and the Internet. DATA SYNTHESIS: Several prospective studies have assessed the efficacy of continuous cycle OCs in preventing monthly withdrawal bleeding. Monophasic OCs are useful for this purpose. In studies using traditional OC regimens as a control, patients receiving continuously administered OCs experienced more breakthrough bleeding and spotting. Continuous use of OCs decreased headache and other menstruation-associated symptoms. No long-term trials have assessed the impact of continuous use of OCs on risk of cancer, thromboembolic disease, or fertility, concerns raised by opponents of the method. CONCLUSIONS: From the data available, continuous use of OCs is an effective method for delaying withdrawal bleeding. Long-term safety data are not available.