Reducing the frequency of menses: extended contraception, a review

The extended use of combined hormonal contraception contributes to a reduction of the frequency of menses by shortening the hormone free interval or the number of withdrawal weeks by year. Numerous regimen have been studied, with cycles from 49 to 365days. Most extended/continuous cycle regimens result in fewer scheduled bleeding episodes but in more unscheduled bleedings or spottings, that decrease with time. An extended contraception may be effective in reducing some menstrual symptoms such as menorrhagia or dysmenorrhea, or some menstrual related symptoms such as migraine headaches. This article reviews existing data about extended combined hormonal contraception, women's and providers' attitude, bleeding pattern, efficacy and tolerance.