title: Women's experiences with tailored use of a combined oral contraceptive: a qualitative study.
abstract: OBJECTIVE
  What are women's experiences with tailored use of combined oral contraceptive pills (COCPs)?
  
  
  CONCLUSIONS
  Some women reported very positive experiences with tailored use of COCPs, others did not like the unpredictability about when they would bleed and some women reported increased anxiety about possible pregnancy.
  
  
  BACKGROUND
  While many studies have investigated views toward extended use of COCPs, little research has examined women's actual experiences with these regimens.
  
  
  METHODS
  This was a semi-structured qualitative interview study that was part of a larger randomized trial of a standard (21 daily pills followed by a 7-day pill-free interval) versus a tailored regimen (daily pills until 3-consecutive-day bleeding triggers a 3-day pill-free interval) of Microgynon 30® mcg (Ethinyl estradiol 30 mcg, Levonorgestrel 150 mcg).
  
  
  METHODS
  Interviews were conducted with 26 women (17 in the tailored group and 9 who switched their assigned treatment group) . Data were analyzed using thematic analysis.
  
  
  RESULTS
  Women discussed positive changes associated with tailored use of COCPs, as well as some negative consequences. The major themes identified in the interview data were: ease of tailored regimen; changes in cycle-related symptoms; adjustment to reduced/absent bleeding and unpredictability about bleeding.
  
  
  CONCLUSIONS
  The sample comprised mainly young, nulliparous women. The majority of women were using COCPs at the start of the study.
  
  
  CONCLUSIONS
  Clinicians discussing extended-use regimes with patients should mention that women may need time to adjust to an extended-use regime. Future research should attempt to identify predictors of response to extended use of COCPs.
authors.affiliation: Department of Psychology, University of Southampton, Southampton, UK SO17 1BJ. c.a.graham@soton.ac.uk
authors.forename: C A
authors.initials: CA
authors.lastname: Graham
authors.forename: S
authors.initials: S
authors.lastname: Panicker
authors.forename: J
authors.initials: J
authors.lastname: Shawe
authors.forename: J
authors.initials: J
authors.lastname: Stephenson
mesh_terms: D000293:Adolescent; D000328:Adult; D003267:Contraception / Q000379:methods / Q000523:psychology*; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects / Q000627:therapeutic use*; D004338:Drug Combinations; D004997:Ethinyl Estradiol / Q000009:adverse effects; D005260:Female; D006801:Humans; D016912:Levonorgestrel / Q000009:adverse effects; D008796:Metrorrhagia / Q000523:psychology; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic
chemical_list: D003277:Contraceptives, Oral, Combined; D004338:Drug Combinations; C072593:ethinyl estradiol, levonorgestrel drug combination; D004997:Ethinyl Estradiol; D016912:Levonorgestrel
keywords: combined oral contraceptives; contraception; experience; qualitative study