title: Effects of a combined oral contraceptive containing oestradiol valerate/dienogest on hormone withdrawal-associated symptoms: results from the multicentre, randomised, double-blind, active-controlled HARMONY II study.
abstract: The objective of this multicentre, randomised, double-blind study was to compare a combined oral contraceptive (COC) containing oestradiol valerate/dienogest (E2V/DNG) administered in a dynamic dosing regimen with a monophasic COC containing ethinyloestradiol/levonorgestrel (EE/LNG), with regard to their ability to reduce the frequency and intensity of headache and pelvic pain in women with hormone withdrawal-associated symptoms (HWAS). Women aged 18-50 years received E2V/DNG in an oestrogen step-down and progestin step-up regimen (26/2 regimen; n = 223) or EE 20 μg/LNG 100 μg (21/7 regimen; n = 218) over six cycles. Headache and pelvic pain were assessed using a visual analogue scale (VAS) during cycle days 22-28. Rescue medication use was also assessed. E2V/DNG was superior to EE/LNG with regard to reducing the frequency and intensity of headache and pelvic pain from baseline to cycle 6 (change from baseline in the average of the three highest VAS values [mean ± standard deviation]: 47.7 ± 29.4 vs 34.5 ± 25.7 mm, respectively; p < 0.0001). The use of rescue medication was also significantly reduced with E2V/DNG compared with EE/LNG (p < 0.05). E2V/DNG may be a good option for women who experience HWAS with traditional 21/7-day regimen COCs.
authors.affiliation: Mexican Institute of Clinical Research, Mexico City, Mexico.
authors.forename: G
authors.initials: G
authors.lastname: Macìas
authors.forename: G S
authors.initials: GS
authors.lastname: Merki-Feld
authors.forename: S
authors.initials: S
authors.lastname: Parke
authors.forename: U
authors.initials: U
authors.lastname: Mellinger
authors.forename: M
authors.initials: M
authors.lastname: Serrani
mesh_terms: D000328:Adult; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage / Q000009:adverse effects*; D004311:Double-Blind Method; D004958:Estradiol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004997:Ethinyl Estradiol / Q000008:administration & dosage; D005260:Female; D006261:Headache / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D016912:Levonorgestrel / Q000008:administration & dosage; D009277:Nandrolone / Q000008:administration & dosage / Q000031:analogs & derivatives*; D017699:Pelvic Pain / Q000209:etiology / Q000517:prevention & control; D013375:Substance Withdrawal Syndrome / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D003277:Contraceptives, Oral, Combined; D004997:Ethinyl Estradiol; C023635:dienogest; D004958:Estradiol; D016912:Levonorgestrel; D009277:Nandrolone