Reduce the hormone-free interval
by having her take COCs for 3 to 4 days instead of 7 days, or eliminate the hormone-free interval
altogether by continuous use of COCs, usually 3 months at a time.
Modifying the 7-day hormone-free interval
(HFI) has also been investigated and is currently beginning to appear in COCs.
* Adoption of the concepts of "scheduled" versus "unscheduled" bleeding (ie, bleeding that occurs during a hormone-free interval
[HFI] versus that occurring during active treatment)
The pill shortens the hormone-free interval
from seven to two days and aims to end the withdrawals.
Numerous studies over the last decade have documented that lowering the doses of hormones in OCs without altering the standard 7-day hormone-free interval
(HFI) compromises suppression effects and can induce hormone withdrawal symptoms.
Other data suggest shortening the hormone-free interval
during oral contraceptive regimens to 3-4 days can improve some symptoms.
If you miss pills in the third week, skip the hormone-free interval
and continue with three more weeks of active pills from a new pack.
Adding estrogen-progestin pills or estrogen-only pills to the standard 7-day hormone-free interval
(as Lo Loestrin Fe does) decreases both secretion of LH and FSH and ovarian follicle activity.
Shortened hormone-free interval
OCs: Less breakthrough ovulation
In another study that compared follicular suppression by means of manipulation of the hormone-free interval
with three different OC regimens, women receiving supplementation with 5 days of 10 mcg ethinyl estradiol had fewer and smaller follicles than women who had a 7-day hormone-free interval
The greater number of scheduled bleeding days in the 21/7-day NGM/EE group than in the 24/4-day DRSP/EE group was expected based on the longer hormone-free interval
. However, among those trial participants who reported scheduled bleeding, the duration of scheduled bleeding was similar for the 20C formulations.
Menstruation-related complaints, such as breast tenderness, headache, bloating, and cramping, occur at significantly higher rates during the hormone-free interval
than during the active-pill interval.