title: Evaluation of pituitary-ovarian axis suppression with three oral contraceptive regimens.
abstract: BACKGROUND
  The study was conducted to evaluate follicular development and hormone patterns with three oral contraceptive (OC) regimens before, during and after the 7-day hormone-free interval (HFI) or 7-day ethinyl estradiol (EE)-supplemented interval.
  
  
  METHODS
  The study is a single-center, open-label, prospective, randomized trial to evaluate pituitary-ovarian suppression with three OC regimens containing identical hormones: 30 mcg of EE and 150 mcg of levonorgestrel (LNG).
  
  
  METHODS
  After a standard 21/7 OC baseline cycle, subjects were randomized to one of three treatment groups: (1) three 21/7-day cycles of 150 mcg LNG/30 mcg EE for 21 days followed by 7 days of placebo (n=10); (2) one 84/7-day cycle of 150 mcg LNG/30 mcg EE for 84 days followed by 7 days of placebo (n=12) and (3) one 84/7EE-day cycle of 150 mcg LNG/30 mcg EE for 84 days followed by 7 days of 10 mcg EE (n=11). Estradiol; follicle-stimulating hormone (FSH); luteinizing hormone and inhibin-B levels, ovarian follicles and daily symptom diaries were collected.
  
  
  RESULTS
  Compared to subjects receiving placebo during the 7-day HFI, those receiving EE demonstrated reductions (p<.05) in both FSH and estradiol. Number of developing follicles was less after the 7-day EE interval compared to that after 7-day HFI. Subjects on the 84/7 and 84/7EE regimens reported less (p=.03) daily menstrual flow than those on the 21/7-day regimen. A trend (p=.06) toward reduced headaches during the 7-day EE-supplemented interval was noted.
  
  
  CONCLUSIONS
  Supplementation of the standard 7-day HFI with 10 mcg EE after 84 days of an extended OC decreased FSH levels and decreased the number of developing follicles.
authors.affiliation: Department of Obstetrics and Gynecology, Scott and White Clinic and Memorial Hospital, Texas A&M University Health Science Center College of Medicine, Temple, TX 76508, USA.
authors.forename: Misty A
authors.initials: MA
authors.lastname: Vandever
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Kuehl
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Sulak
authors.forename: Iris
authors.initials: I
authors.lastname: Witt
authors.forename: Andrea
authors.initials: A
authors.lastname: Coffee
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Wincek
authors.forename: Kathleen Z
authors.initials: KZ
authors.lastname: Reape
mesh_terms: D000328:Adult; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage*; D003280:Contraceptives, Oral, Synthetic / Q000008:administration & dosage; D004334:Drug Administration Schedule; D004958:Estradiol / Q000097:blood; D004997:Ethinyl Estradiol / Q000008:administration & dosage*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007265:Inhibins / Q000097:blood; D016912:Levonorgestrel / Q000008:administration & dosage*; D007986:Luteinizing Hormone / Q000097:blood; D006080:Ovarian Follicle / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000502:physiology; D010902:Pituitary Gland / Q000187:drug effects* / Q000502:physiology; D011446:Prospective Studies; D014463:Ultrasonography
chemical_list: D003277:Contraceptives, Oral, Combined; D003280:Contraceptives, Oral, Synthetic; C422364:inhibin B; D004997:Ethinyl Estradiol; D004958:Estradiol; D007265:Inhibins; D016912:Levonorgestrel; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone