Bleeding patterns after immediate vs. conventional oral contraceptive initiation: a randomized, controlled trial.
OBJECTIVE
To compare bleeding patterns after immediate vs. conventional oral contraceptive (OC) initiation.


METHODS
Randomized controlled trial.


METHODS
University-based clinic.


METHODS
One hundred thirteen women initiating combination OCs.


METHODS
Participants received a 4-month supply of a monophasic 35-microg ethinyl E(2) (EE) OC and a bleeding diary, were randomized to immediate or conventional OC start, underwent monthly telephone follow-up, and after 90 days returned the diary and completed an exit interview.


METHODS
Total number of bleeding-spotting days, using the World Health Organization 90-day reference period method. Comparisons were made by trial assignment (immediate vs. conventional) and cycle day of OC initiation (day 8+ vs. days 1-7).


RESULTS
There was no significant difference in the number of bleeding-spotting days (mean difference: -0.5 days; 95% CI: -3.4 to 2.3) or any other bleeding parameter between the immediate and conventional starters, or days 1-7 and day 8+ starters.


CONCLUSIONS
Immediate start of OCs does not induce bleeding patterns different from conventional starting regimens. Concern about adverse bleeding patterns should not be considered a justification for instructing women to wait until menses before starting OCs.
Westhoff
Carolyn
C
Department of Obstetrics and Gynecology, Columbia University, New York, New York 10032, USA. clw3@columbia.edu
Morroni
Chelsea
C
Kerns
Jennifer
J
Murphy
Patricia Aikins
PA
D000328:Adult; D001824:Body Constitution; D003276:Contraceptives, Oral / Q000494:pharmacology*; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008597:Menstrual Cycle / Q000187:drug effects / Q000502:physiology*; D018579:Patient Selection; D012907:Smoking; D013997:Time Factors
D003276:Contraceptives, Oral