Oral contraception and cyclic changes in premenstrual and menstrual experiences

Abstract

Despite the widespread use of oral contraceptives (OC) there is no consensus regarding their effect on menstrual cycle experiences. This study examines the cyclic changes of prospectively collected, daily menstrual cycle experiences of two groups of 'healthy women' using monophasic and triphasic OC compared with a group using non-hormonal contraception. A total of 119 'healthy women' using monophasic, triphasic or non-hormonal contraception for three months, made daily ratings over at least two complete menstrual cycles. Cyclic changes of ratings within and between the groups were analyzed. The three groups showed significant cyclic changes in abdominal fullness, abdominal discomfort, breast fullness, general 'premenstrual syndrome-like symptoms' and in at least two mood ratings. Maximal changes in ratings occurred during the late premenstrual and menstrual phases. There were no significant differences between the three groups in cyclic changes for any physical rating, but there were for tiredness or fatigue (non-OC users reported experiencing tiredness or fatigue more frequently than the OC users) and sadness or depression (non-OC users experienced sadness or depression less frequently than OC users during the early part of the cycle, followed by a sharp rise from early premenstrual to the menstrual phase). There were no significant cyclic differences in ratings between the monophasic and triphasic groups. In conclusion, 'healthy women' using OC experience premenstrual and menstrual changes. Any differences between OC formulations are subtle and not of clinical significance in 'healthy women' already established on monophasic or triphasic hormonal contraception.