title: Extending the duration of active oral contraceptive pills to manage hormone withdrawal symptoms.
abstract: OBJECTIVE
  To test the hypothesis that extending the number of consecutive active oral contraceptives (OC)s given will decrease the frequency of menstrual-related problems including dysmenorrhea, menorrhagia, premenstrual-type symptoms, and menstrual migraines.
  
  
  METHODS
  A prospective analysis was designed to track the experiences of 50 women taking OCs and experiencing menstrual-related problems. Fifty consecutive patients, who were taking OCs and had symptoms during the pill-free interval, were followed in a multispecialty clinic by an individual physician and nurse practitioner team. The patients were permitted to extend the number of consecutive active OCs to delay menstrual-related symptoms.
  
  
  RESULTS
  Immediate outcome of the 50 patients revealed 74% (37 patients) stabilized on an extended regimen of 6 to 12 weeks of consecutive days with active OCs. Twenty-six percent (13 patients) either discontinued OCs or returned to the standard regimen with 3 weeks of active pills. Of the 37 patients who were stabilized on an extended regimen, 27 have completed thus far between five and 13 extended cycles with 6-23 months of follow-up (mean 16 months).
  
  
  CONCLUSIONS
  Experience in a series of 50 OC users with menstrual-related symptoms demonstrated that delaying menses by extending the number of consecutive days of active pills is well tolerated and efficacious. We believe that a large prospective study is warranted to further our knowledge in this area.
authors.affiliation: Department of Obstetrics and Gynecology, Scott & White Clinic and Memorial Hospital, Texas A & M University Health Science Center College of Medicine, Temple, USA.
authors.forename: P J
authors.initials: PJ
authors.lastname: Sulak
authors.forename: B E
authors.initials: BE
authors.lastname: Cressman
authors.forename: E
authors.initials: E
authors.lastname: Waldrop
authors.forename: S
authors.initials: S
authors.lastname: Holleman
authors.forename: T J
authors.initials: TJ
authors.lastname: Kuehl
mesh_terms: D000328:Adult; D003276:Contraceptives, Oral / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008599:Menstruation Disturbances / Q000139:chemically induced / Q000517:prevention & control*; D008875:Middle Aged; D011446:Prospective Studies; D013375:Substance Withdrawal Syndrome / Q000209:etiology / Q000517:prevention & control*; D013997:Time Factors
chemical_list: D003276:Contraceptives, Oral