Treatment satisfaction, adherence, and menstrual symptoms among women in the United States using extended-cycle and monthly-cycle oral contraception
Rossella Nappi (IT), Iñaki Lete (ES), Lulu Lee (US), Natalia Flores (US), Marie-Christine Micheletti (NL), Boxiong Tang (US)
[Nappi] Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause , [Lete] Araba University Hospital, [Lee] Kantar Health, [Flores] Kantar Health , [Micheletti] Teva Europe Women’s Health, [Tang] Teva Pharmaceuticals
Context: Women in the United States (US) seeking oral contraception (OC) have the option of monthly-cycle (3-4 weeks between periods) or extended-cycle (3 months between periods) therapies. Objective: To examine whether women in the US using extended- vs. monthly-cycle OC differ on treatment satisfaction, adherence, and menstrual symptoms. Methods: The 2013 US National Health and Wellness Survey (NHWS) was used as the data source. Respondents were grouped as using extended- or monthly-cycle OC. Patients: Women included were 18-50 years old, premenopausal, without hysterectomy, who reported current use of OC. Intervention: US data from the NHWS (N=75,000) were examined. Main Outcome Measure(s): Outcomes included treatment satisfaction (1: extremely dissatisfied to 7: extremely satisfied), adherence (8-item Morisky Medication Adherence Scale), presence of heavy menstrual bleeding, and presence of menstrual pain. Covariates examined were demographics, health characteristics, and comorbidities. Results: Among all respondents (n=3,876) included in the study, 6.7% (n=260) were on extended-cycle and 93.3% (n=3,616) were on monthly-cycle OC. After controlling for covariates, women on extended-cycle reported higher treatment satisfaction (adjusted means=6.06 vs 5.81, p=0.001) and less non-adherence (adjusted means=1.38 vs 1.59, p=0.05) than women on monthly-cycle OC. Women on extended-cycle experienced less heavy menstrual bleeding (adjusted means=8.56% vs 13.04%, p=0.029). Women on extended-cycle OC appeared to have experienced less menstrual pain; however, differences were not statistically significant (adjusted means=39.49% vs 47.31%, p=0.195). Conclusions: These findings demonstrated higher treatment satisfaction and greater adherence for extended-cycle compared with monthly-cycle OC. Additionally, women on extended-cycle OC experienced less heavy menstrual bleeding.