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Bleeding Similar After Immediate Versus Conventional Start Of Contraceptives

Bleeding patterns are no different after immediate start of oral contraceptives (OCs) than after conventional starting regimens, researchers in the United States have found.

There is no justification for instructing women to wait until menses before beginning OCs, suggests this study from the Department of Obstetrics and Gynecology, Columbia University, New York.

This randomised controlled trial by Dr C Westhoff and colleagues compared bleeding patterns after immediate versus conventional OC initiation. Participants were 113 women at one university-based clinic who were starting combination OCs.

The women all received a 4-month supply of a monophasic 35-microg ethinyl E(2) (EE) OC and a diary to record bleeding and were randomly assigned to either immediate or conventional initiation of OC use.

They were followed up monthly by telephone and, after 90 days, returned their diaries and completed exit interviews.

Investigators defined the main outcome measure as the total number of bleeding-spotting days according to the World Health Organization 90-day reference period method.

They made the comparison by trial assignment (immediate versus conventional) and by cycle day of OC initiation (day 8 plus versus days 1 through 7).

No significant difference emerged in bleeding-spotting days or in any other bleeding parameter between the immediate and conventional starters or between those who started on days one through seven versus on day eight plus.
Fertil Steril 2003 Feb;79:2:322-9. "Bleeding patterns after immediate vs. conventional oral contraceptive initiation: a randomized, controlled trial."

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