Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2012 Jun;119(6):1143-50.
doi: 10.1097/AOG.0b013e318257217a.

Continuous compared with cyclic oral contraceptives for the treatment of primary dysmenorrhea: a randomized controlled trial

Romana Dmitrovic  1 , Allen R Kunselman, Richard S Legro
Affiliations
Randomized Controlled Trial

Continuous compared with cyclic oral contraceptives for the treatment of primary dysmenorrhea: a randomized controlled trial

Romana Dmitrovic et al. Obstet Gynecol. 2012 Jun.

Abstract

Objective: To estimate whether continuous oral contraceptive pills (OCPs) will result in more pain relief in primary dysmenorrhea patients than cyclic OCPs, which induce withdrawal bleeding with associated pain and symptoms.

Methods: We conducted a double-blind, randomized, controlled trial comparing continuous to a cyclic 21-7 OCP regimen (gestodene 0.075 mg and ethinyl estradiol 20 microgram) for 6 months in 38 primary dysmenorrhea patients. The primary outcome was the difference in subjective perception of pain as measured by the visual analog scale over a period of 6 months.

Results: Twenty-nine patients completed the study. In both groups, pain reduction measured by visual analog scale declined over time and was significant at 6 months compared with baseline, with no difference between groups. Continuous regimen was superior to cyclic regimen after 1 month (mean difference -27.3, 95% confidence interval [CI] -40.5 to -14.2; P<.001) and 3 months (mean difference -17.8, 95% CI -33.4 to -2.1; P=.03) of treatment. Secondary outcomes noted no difference between groups in terms of menstrual distress as measured by the Moos Menstrual Distress Questionnaire. After 6 months, there was an increase in weight and a decrease in systolic blood pressure in the continuous group compared with the cyclic group.

Conclusion: Both regimens of OCPs are effective in the treatment of primary dysmenorrhea. Continuous OCPs outperform cyclic OCPs in the short term, but this difference is lost after 6 months.

Clinical trial registration: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00517556.

Level of evidence: I.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow of participants through the study.
Figure 2
Figure 2
Comparisons between the two groups in Visual Analogue Scores (VAS) at varying time points in the study.
See this image and copyright information in PMC

References

    1. Andersch B, Milsom I. An epidemiologic study of young women with dysmenorrhea. Am J Obstet Gynecol. 1982;144(6):655–660. - PubMed
    1. Dawood MY. Ibuprofen and dysmenorrhea. Am J Med. 1984;77(1A):87–94. - PubMed
    1. Hauksson A, Akerlund M, Melin P. Uterine blood flow and myometrial activity at menstruation, and the action of vasopressin and a synthetic antagonist. Br J Obstet Gynaecol. 1988;95(9):898–904. - PubMed
    1. Pulkkinen MO. Prostaglandins and the non-pregnant uterus. The pathophysiology of primary dysmenorrhea. Acta Obstet Gynecol Scand Suppl. 1983;113:63–67. - PubMed
    1. Akerlund M. Vascularization of human endometrium. Uterine blood flow in healthy condition and in primary dysmenorrhoea. Ann N Y Acad Sci. 1994;734:47–56. - PubMed

Publication types

Associated data