Pituitary-ovarian hormone levels and symptoms in oral contraceptive users: comparison of a 21/7-day and extended regimen.
OBJECTIVE
To compare hormone levels and symptoms during transition from standard to extended oral contraceptive (OC) regimens.


METHODS
A prospective analysis of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, and inhibin-B levels with symptoms during 21/7-day vs. 168/7-day extended OCs containing 3 mg of drosperinone and 30 mcg of ethinyl estradiol. Blood samples were obtained from 10 subjects in each of 4 weeks in the 21/7 regimen, in the first 6 weeks of the extended regimen, and again the week before, the week of and the week after the 7-day hormone-free interval (HFI) at the end of the extended regimen.


RESULTS
All 4 hormones followed a cyclic pattern with decreasing levels during the 3 active pill weeks of the 21/7 cycle, followed by an increase during the 7-day HFI, which continued into the extended regimen. Levels then decreased during the extended regimen and remained low at week 24. During the 7-day HFI after the extended regimen FSH and LH again increased above baseline (p > 0.07). Hormone withdrawal symptoms increased at the end of 21 active pills with increasing severity during the 7-day HFI.


CONCLUSIONS
Absence of pituitary and ovarian suppression associated with HFI leads to fluctuations in hormones and associated hormone withdrawal symptoms.
Kuehl
Thomas J
TJ
Department of Obstetrics and Gynecology, Scott & White Clinic Memorial Hospital and Clinic, Texas A&M University Health Science Center College of Medicine, Temple 76504, USA. tkuehl@swmail.sw.org
Speikermann
A Michael
AM
Willis
Sherilyn A
SA
Coffee
Andrea
A
Sulak
Patricia J
PJ
D000328:Adult; D000736:Androstenes / Q000008:administration & dosage; D015331:Cohort Studies; D003276:Contraceptives, Oral / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004958:Estradiol / Q000097:blood*; D004967:Estrogens / Q000008:administration & dosage; D004997:Ethinyl Estradiol / Q000008:administration & dosage; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D007265:Inhibins / Q000097:blood*; D007986:Luteinizing Hormone / Q000097:blood*; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000008:administration & dosage; D011446:Prospective Studies
D000736:Androstenes; D003276:Contraceptives, Oral; D004967:Estrogens; D000451:Mineralocorticoid Receptor Antagonists; C422364:inhibin B; D004997:Ethinyl Estradiol; D004958:Estradiol; D007265:Inhibins; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; C035144:drospirenone