Extending the duration of active oral contraceptive pills to manage hormone withdrawal symptoms

Obstet Gynecol. 1997 Feb;89(2):179-83. doi: 10.1016/S0029-7844(96)00488-7.


Objective: To test the hypothesis that extending the number of consecutive active oral contraceptives (OC)s given will decrease the frequency of menstrual-related problems including dysmenorrhea, menorrhagia, premenstrual-type symptoms, and menstrual migraines.

Methods: A prospective analysis was designed to track the experiences of 50 women taking OCs and experiencing menstrual-related problems. Fifty consecutive patients, who were taking OCs and had symptoms during the pill-free interval, were followed in a multispecialty clinic by an individual physician and nurse practitioner team. The patients were permitted to extend the number of consecutive active OCs to delay menstrual-related symptoms.

Results: Immediate outcome of the 50 patients revealed 74% (37 patients) stabilized on an extended regimen of 6 to 12 weeks of consecutive days with active OCs. Twenty-six percent (13 patients) either discontinued OCs or returned to the standard regimen with 3 weeks of active pills. Of the 37 patients who were stabilized on an extended regimen, 27 have completed thus far between five and 13 extended cycles with 6-23 months of follow-up (mean 16 months).

Conclusions: Experience in a series of 50 OC users with menstrual-related symptoms demonstrated that delaying menses by extending the number of consecutive days of active pills is well tolerated and efficacious. We believe that a large prospective study is warranted to further our knowledge in this area.

Publication types

  • Review

MeSH terms

  • Adult
  • Contraceptives, Oral / administration & dosage*
  • Contraceptives, Oral / adverse effects
  • Female
  • Follow-Up Studies
  • Humans
  • Menstruation Disturbances / chemically induced
  • Menstruation Disturbances / prevention & control*
  • Middle Aged
  • Prospective Studies
  • Substance Withdrawal Syndrome / etiology
  • Substance Withdrawal Syndrome / prevention & control*
  • Time Factors


  • Contraceptives, Oral