A delayed starting schedule of oral contraception: the effect on the incidence of breakthrough bleeding and compliance in women.
OBJECTIVE
To assess the effect of oral contraception started on the first day of menses and the fifth day following its onset, on women's compliance and the incidence of early breakthrough bleeding.


METHODS
Oral contraceptives (OCs) containing 30 micrograms ethinylestradiol and 75 micrograms gestodene were prescribed to 100 consecutive, healthy women for whom OCs were found to be the most suitable method of contraception. In the first 50 women, OCs were started on the first day of menses (day 1 group), while in the remaining 50 women, OCs were started on the fifth day after the onset of menses (day 5 group).


RESULTS
The day 5 group had better compliance and a reduced incidence of breakthrough bleeding. No differences were observed between the two groups regarding age, parity and gravity.


CONCLUSIONS
Starting an OC regimen should include initiation on the fifth day following the onset of menses. This regimen might increase patient compliance and lower the incidence of breakthrough bleeding.
Department of Obstetrics and Gynecology, Rabin Medical Center, Petah Tiqva, Israel.
A
A
Yeshaya
R
R
Orvieto
A
A
Kauschansky
D
D
Dicker
A
A
Dekel
I
I
Bar-Hava
Z
Z
Ben-Rafael
D000293:Adolescent; D000328:Adult; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D045166:Estradiol Congeners / Q000008:administration & dosage* / Q000009:adverse effects; D004997:Ethinyl Estradiol / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008597:Menstrual Cycle / Q000187:drug effects* / Q000523:psychology; D009652:Norpregnenes / Q000008:administration & dosage* / Q000009:adverse effects; D010349:Patient Compliance / Q000523:psychology*; D045167:Progesterone Congeners / Q000008:administration & dosage* / Q000009:adverse effects; D013997:Time Factors; D014592:Uterine Hemorrhage / Q000139:chemically induced* / Q000523:psychology
D003277:Contraceptives, Oral, Combined; D045166:Estradiol Congeners; D009652:Norpregnenes; D045167:Progesterone Congeners; C033273:Gestodene; D004997:Ethinyl Estradiol