Continuous, daily levonorgestrel/ethinyl estradiol vs. 21-day, cyclic levonorgestrel/ethinyl estradiol: efficacy, safety and bleeding in a randomized, open-label trial

Contraception. 2009 Dec;80(6):504-11. doi: 10.1016/j.contraception.2009.05.128. Epub 2009 Aug 6.

Abstract

Background: This Phase 3, randomized, open-label, multicenter study conducted at 44 sites in Europe evaluated the safety and efficacy of a continuous, daily regimen of levonorgestrel (LNG) 90 mcg/ethinyl estradiol (EE) 20 mcg compared with a 21-day, cyclic LNG 100 mcg/EE 20 mcg regimen.

Study design: Three hundred twenty-three healthy women were randomized to continuous LNG 90 mcg/EE 20 mcg and 318 subjects to cyclic LNG 100 mcg/EE 20 mcg for 1 year (13 pill packs). Pearl index, adverse event (AE) incidence and bleeding profiles were assessed.

Results: No pregnancies occurred with the continuous oral contraceptive (OC) (Pearl index=0.00). As the study progressed, the percentage of women who achieved amenorrhea during each 28-day pill pack increased: 40% at pill pack 7, 53% at pill pack 13. The percentage of women with no bleeding [with or without spotting (defined as not requiring sanitary protection)] was 50%, 69% and 79% at pill packs 3, 7 and 13, respectively. The incidence of AEs was similar to that of the cyclic OC (except for metrorrhagia and vaginal bleeding in the first 6 months).

Conclusions: Continuous LNG 90 mcg/EE 20 mcg was shown to be a safe and effective OC in this direct comparison to a cyclic OC. Suppression of menses and the potential for no bleeding requiring sanitary protection may be provided by this continuous, low-dose OC.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Contraceptives, Oral, Combined / administration & dosage
  • Contraceptives, Oral, Combined / adverse effects
  • Drug Administration Schedule
  • Drug-Related Side Effects and Adverse Reactions*
  • Ethinyl Estradiol / administration & dosage*
  • Ethinyl Estradiol / adverse effects*
  • Female
  • Humans
  • Levonorgestrel / administration & dosage*
  • Levonorgestrel / adverse effects*
  • Longitudinal Studies
  • Metrorrhagia* / chemically induced
  • Middle Aged
  • Patient Selection
  • Pregnancy, Unplanned
  • Statistics, Nonparametric

Substances

  • Contraceptives, Oral, Combined
  • Ethinyl Estradiol
  • Levonorgestrel