Continuous compared with cyclic oral contraceptives for the treatment of primary dysmenorrhea: a randomized controlled trial
Obstetrics and Gynecology, 05/23/2012
Clinical Article
Dmitrovic R et al. – Both regimens of OCPs are effective in the treatment of primary dysmenorrhea. Continuous OCPs outperform cyclic OCPs in the short term, but this difference is lost after 6 months.
Methods- We conducted a double–blind, randomized, controlled trial comparing continuous to a cyclic 21–7 OCP regimen (gestodene 0.075 mg and ethinyl estradiol 20 microgram) for 6 months in 38 primary dysmenorrhea patients.
- The primary outcome was the difference in subjective perception of pain as measured by the visual analog scale over a period of 6 months.
- Twenty–nine patients completed the study. In both groups, pain reduction measured by visual analog scale declined over time and was significant at 6 months compared with baseline, with no difference between groups.
- Continuous regimen was superior to cyclic regimen after 1 month (mean difference –27.3, 95% confidence interval [CI] –40.5 to –14.2; P<.001) and 3 months (mean difference –17.8, 95% CI –33.4 to –2.1; P=.03) of treatment.
- Secondary outcomes noted no difference between groups in terms of menstrual distress as measured by the Moos Menstrual Distress Questionnaire.
- After 6 months, there was an increase in weight and a decrease in systolic blood pressure in the continuous group compared with the cyclic group.



