Panicker Sabeena, Mann Sue, Shawe Jill, Stephenson Judith
Specialist Registrar in Obstetrics & Gynaecology, Sexual and Reproductive Health Research Group, Institute for Women's Health, University College London, London, UK.
J Fam Plann Reprod Health Care. 2014 Apr;40(2):133-41. doi: 10.1136/jfprhc-2013-100600.
Extended use of the combined oral contraceptive pill (COC), defined as taking active pills for at least 28 days, has been used in order to avoid bleeding at important times and to treat gynaecological conditions such as endometriosis. We examined the main issues involved in extended use of the COC and how it has evolved from being one of medicine's best-kept secrets to becoming more widely accepted by women and the medical community.
Literature review, using Medline, Embase, Pubmed, CINHAL Plus, the Cochrane Database of Systematic Reviews and the Ovid database for all relevant clinical trials, systematic reviews, meta-analyses, literature reviews, scientific papers and individual opinions between 1950 and October 2013.
Accumulating evidence supports various forms of extended pill use as suitable alternatives to the standard (21/7) regimen. In terms of user preference, much hinges on whether women wish to reduce the frequency or duration of scheduled bleeding on the combined pill. Available data on the safety of extended pill regimens do not give cause for concern, but longer term data should be collected.
Information for women considering extended COC regimens should keep pace with research findings to ensure that women and clinicians are better informed about the choices available.
复方口服避孕药（COC）的延长使用，定义为连续服用活性药片至少28天，已被用于避免在重要时期出血以及治疗诸如子宫内膜异位症等妇科疾病。我们研究了复方口服避孕药延长使用中涉及的主要问题，以及它是如何从医学上最保守的秘密之一发展到被女性和医学界更广泛接受的。
文献综述，使用Medline、Embase、Pubmed、CINHAL Plus、Cochrane系统评价数据库和Ovid数据库检索1950年至2013年10月期间所有相关的临床试验、系统评价、荟萃分析、文献综述、科学论文和个人观点。
越来越多的证据支持各种形式的延长服药方式可作为标准（21/7）服药方案的合适替代方案。在用户偏好方面，很大程度上取决于女性是否希望减少复方避孕药定时出血的频率或持续时间。关于延长服药方案安全性的现有数据无需担忧，但应收集长期数据。
为考虑使用复方口服避孕药延长方案的女性提供的信息应跟上研究结果，以确保女性和临床医生能更好地了解可用的选择。
