Characteristics of scheduled bleeding manipulation with combined hormonal contraception in university students

Contraception. 2013 Sep;88(3):426-30. doi: 10.1016/j.contraception.2012.12.012. Epub 2013 Jan 8.


Background: There is a lack of information concerning the decision factors and sources of information influencing women who purposefully deviate from the prescribed use of their combined hormone contraceptives to exert elective control of their scheduled bleeding.

Study design: A self-administered email survey of scheduled bleeding practices and beliefs was distributed to 11,900 female students at the University of Oregon. Assessment of survey participant characteristics, scheduled bleeding manipulation features and attitudes and knowledge toward hormonal contraception was analyzed.

Results: Of 1719 respondents to the survey, 1374 (79.9%) reported using combined hormonal contraception currently or recently. Approximately 17% of these women altered their scheduled bleeding pattern by deviating from package instructions. Of these, 50% indicated they delayed or skipped their scheduled bleeding for convenience or personal choice. Within this group, 47% of women indicated they learned to modify their scheduled bleeding from health care professionals, while 30% indicated such knowledge was obtained from family or friends. Characteristics that decreased the likelihood of this practice included being of Asian race, use of hormonal contraceptive for bleeding cycle regulation, following a regular exercise program, and personal preference for a monthly cycle.

Conclusions: The majority of university females who choose to modify their scheduled bleeding cycle with combined hormonal contraceptives do so for convenience rather than to avoid menstrual symptoms, and many learn from nonmedical sources. There is some disparity between the preferences of menstruation frequency and actual scheduled bleeding pattern behaviors, suggesting potential for improvement in patient education.

Keywords: Birth control; Contraceptive; Menstrual cycle; Modification; Women.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Contraceptives, Oral, Combined / administration & dosage*
  • Contraceptives, Oral, Hormonal / administration & dosage*
  • Decision Making
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Menstruation / drug effects*
  • Menstruation / physiology
  • Patient Education as Topic
  • Students
  • Surveys and Questionnaires
  • Universities
  • Young Adult


  • Contraceptives, Oral, Combined
  • Contraceptives, Oral, Hormonal