Continuous Use of COCs

Family Health International has recently initiated a USAID funded study to investigate the pregnancy rates, continuation rates, and acceptability of COCs in women taking COCs by the 21/7 cyclic regimen compared with the continuous use of COCs with bleeding-signaled hormone-free intervals. The primary objective is to determine whether continuous COC use leads to higher 12-month continuation rates than use of the standard 28-day COC regimen. Secondary objectives are to 1) compare pregnancy probabilities through 6 and 12 months between the continuous use group and the 28-day group 2) compare COC continuation rates through 6 months between the continuous use group and the 28-day group 3) compare acceptability of the two COC regimens 4) to compare bleeding and other side effects between the continuous use group and the 28-day group 5) to compare hemoglobin/hematocrit between the continuous use group and the 28-day group

Inclusion criteria

• Age 18-30
• Currently has menstrual periods every 21-35 days
• Willing and able to be randomly assigned to one of the two study groups and to comply with all study requirements
• Has signed the informed consent form
• Has a negative urine pregnancy test at enrollment

Exclusion criteria

• Has contraindications to COC use (see WHO MEC-3rd edition)
• Is in any other research study
• Has been pregnant in the past 3 months
• Is breastfeeding or has breastfed in the past 3 months
• Is currently using an IUD (women who agree to IUD removal are eligible once the IUD is removed)
• Has had an injection of DMPA in the past 6 months
• Has had an injection of NET-EN in the past 3 months
• Has used combined injectables, oral contraceptive pills, implants, or a hormonal IUD in the past 2 months
• Has had any of the following conditions since her last pregnancy, or since menarche if never pregnant:

• Pelvic infection treated with antibiotics
• Diagnosis of infertility
• Endometriosis