Real-world experience of women using extended-cycle vs monthly-cycle combined oral contraception in the United States

The National Health and Wellness Survey

Rossella E. Nappi, Iñaki Lete, Lulu K. Lee, Natalia M. Flores, Marie Christine Micheletti, Boxiong Tang

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: The real-world experience of women receiving extended-cycle combined oral contraception (COC) versus monthly-cycle COC has not been reported. Methods: Data were from the United States 2013 National Health and Wellness Survey. Eligible women (18-50 years old, premenopausal, without hysterectomy) currently using extended-cycle COC (3 months between periods) were compared with women using monthly-cycle COC. Treatment satisfaction (1 "extremely dissatisfied" to 7 "extremely satisfied"), adherence (8-item Morisky Medication Adherence Scale©), menstrual cycle-related symptoms, health-related quality of life (HRQOL) and health state utilities (Medical Outcomes Short Form Survey-36v2®), depression (9-item Patient Health Questionnaire), sleep difficulties, Work Productivity and Activity Impairment-General Health, and healthcare resource use were assessed using one-way analyses of variance, chi-square tests, and generalized linear models (adjusted for covariates). Results: Participants included 260 (6.7%) women using extended-cycle and 3616 (93.3%) using monthly-cycle COC. Women using extended-cycle COC reported significantly higher treatment satisfaction (P = 0.001) and adherence (P = 0.04) and reduced heavy menstrual bleeding (P = 0.029). A non-significant tendency toward reduced menstrual pain (39.5% versus 47.3%) and menstrual cycle-related symptoms (40.0% versus 48.7%) was found in women using extended-cycle versus monthly-cycle COC. Significantly more women using extended-cycle COC reported health-related diagnoses, indicating preferential prescription for extended-cycle COC among women reporting more health problems. Consistent with this poorer health, more women using extended-cycle COC reported fatigue, headache, and activity impairment (P values < 0.05). There were no other significant differences between groups. Conclusions: This real-world observational study supports extended-cycle COC as a valuable treatment option with high satisfaction, high adherence, and reduced heavy menstrual bleeding.

Original languageEnglish
Article number22
JournalBMC Women's Health
Volume18
Issue number1
DOIs
Publication statusPublished - Jan 18 2018

Fingerprint

Health Surveys
Contraception
Health
Menstrual Cycle
Hemorrhage
Dysmenorrhea
Medication Adherence
Health Resources
Women's Health
Chi-Square Distribution
Hysterectomy
Observational Studies
Fatigue
Prescriptions
Headache
Linear Models
Analysis of Variance
Sleep
Therapeutics
Quality of Life

Keywords

  • Adherence
  • Extended-regimen
  • Heavy menstrual bleeding
  • Hormonal contraception
  • Menstrual cycle
  • Real-world
  • Satisfaction
  • Women's health

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology

Cite this

Real-world experience of women using extended-cycle vs monthly-cycle combined oral contraception in the United States : The National Health and Wellness Survey. / Nappi, Rossella E.; Lete, Iñaki; Lee, Lulu K.; Flores, Natalia M.; Micheletti, Marie Christine; Tang, Boxiong.

In: BMC Women's Health, Vol. 18, No. 1, 22, 18.01.2018.

Research output: Contribution to journalArticle

Nappi, Rossella E. ; Lete, Iñaki ; Lee, Lulu K. ; Flores, Natalia M. ; Micheletti, Marie Christine ; Tang, Boxiong. / Real-world experience of women using extended-cycle vs monthly-cycle combined oral contraception in the United States : The National Health and Wellness Survey. In: BMC Women's Health. 2018 ; Vol. 18, No. 1.
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N2 - Background: The real-world experience of women receiving extended-cycle combined oral contraception (COC) versus monthly-cycle COC has not been reported. Methods: Data were from the United States 2013 National Health and Wellness Survey. Eligible women (18-50 years old, premenopausal, without hysterectomy) currently using extended-cycle COC (3 months between periods) were compared with women using monthly-cycle COC. Treatment satisfaction (1 "extremely dissatisfied" to 7 "extremely satisfied"), adherence (8-item Morisky Medication Adherence Scale©), menstrual cycle-related symptoms, health-related quality of life (HRQOL) and health state utilities (Medical Outcomes Short Form Survey-36v2®), depression (9-item Patient Health Questionnaire), sleep difficulties, Work Productivity and Activity Impairment-General Health, and healthcare resource use were assessed using one-way analyses of variance, chi-square tests, and generalized linear models (adjusted for covariates). Results: Participants included 260 (6.7%) women using extended-cycle and 3616 (93.3%) using monthly-cycle COC. Women using extended-cycle COC reported significantly higher treatment satisfaction (P = 0.001) and adherence (P = 0.04) and reduced heavy menstrual bleeding (P = 0.029). A non-significant tendency toward reduced menstrual pain (39.5% versus 47.3%) and menstrual cycle-related symptoms (40.0% versus 48.7%) was found in women using extended-cycle versus monthly-cycle COC. Significantly more women using extended-cycle COC reported health-related diagnoses, indicating preferential prescription for extended-cycle COC among women reporting more health problems. Consistent with this poorer health, more women using extended-cycle COC reported fatigue, headache, and activity impairment (P values < 0.05). There were no other significant differences between groups. Conclusions: This real-world observational study supports extended-cycle COC as a valuable treatment option with high satisfaction, high adherence, and reduced heavy menstrual bleeding.

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