Department of Medical and Surgical Sciences for Mother, Child and Adult, Obstetrics and Gynecology Unit, University of Modena and Reggio Emilia, Azienda Ospedaliero Universitaria Policlinico, Via del Pozzo 71, 41124, Modena, Italy.
Arch Gynecol Obstet. 2023 Mar;307(3):873-879. doi: 10.1007/s00404-022-06853-1. Epub 2022 Nov 21.
A new POP consisting of 4 mg drospirenone (DRSP) for 24 days with a 4-day hormone-free interval was developed to improve bleeding predictability during POP use. The aim of this study was to evaluate the effect on bleeding patterns during use of this oral contraceptive (OC) in comparison with previous menstrual cycles before the start of OC use.
This is a pilot, prospective trial. A diary was used to collect information about daily bleeding and pelvic pain before and during treatment. During OC use, women were categorised as having (1) unscheduled bleeding or spotting days (UB), (2) scheduled bleeding or spotting days (SB) and (3) absence of bleeding/spotting (AB). SF-36 and FSFI questionnaires were used to quantify health-related quality of life and the quality of sexual life in sexually active participants.
Eighteen out of twenty-five (72%) women completed the entire follow-up. Women with UB (44.4%) were older at inclusion (p < 0.001) and had higher BMIs (p = 0.02) than those with AB (22.2%) or SB (33.4%). Women recorded a significant reduction of menstrual flow intensity during OC use (p < 0.0001). Those with UB also experienced a significant reduction of menstrual pain intensity (p = 0.006). Women with SB during OC use had a longer baseline cycle than those who reported UB during OC use (p = 0.008). Satisfaction with this OC was very high (8.4 ± 2.2 points) with no modification in SF-36 and FSFI values.
A DRSP-only pill is a good OC option for women with contraindications to oestrogen use. Features of the menstrual cycle before the start of OC use may be used to predict associated changes in bleeding patterns.
一种新的孕激素避孕药（POP），含有 4 毫克屈螺酮（DRSP），使用 24 天，停药 4 天，旨在改善 POP 使用期间的出血可预测性。本研究旨在评估与开始使用 POP 之前的前几个月经周期相比，使用这种口服避孕药（OC）对出血模式的影响。
这是一项前瞻性的试点研究。使用日记来收集治疗前和治疗期间每日出血和盆腔疼痛的信息。在 OC 使用期间，女性被分为（1）无计划出血或点滴天数（UB）、（2）计划出血或点滴天数（SB）和（3）无出血/点滴天数（AB）。SF-36 和 FSFI 问卷用于量化有性生活的参与者的健康相关生活质量和性生活质量。
25 名女性中有 18 名（72%）完成了整个随访。UB 组（44.4%）的女性年龄较大（p<0.001），BMI 较高（p=0.02），AB 组（22.2%）或 SB 组（33.4%）。女性在 OC 使用期间记录到月经流量强度显著降低（p<0.0001）。UB 组的月经疼痛强度也显著降低（p=0.006）。在 OC 使用期间报告 UB 的女性的基线周期比报告 SB 的女性长（p=0.008）。对这种 OC 的满意度非常高（8.4±2.2 分），SF-36 和 FSFI 值没有变化。
对于有雌激素使用禁忌的女性，DRSP 单一孕激素避孕药是一种很好的 OC 选择。OC 使用前的月经周期特征可用于预测相关出血模式的变化。
