Priority 7 from the Contraception PSP

UNCERTAINTY: What are the risks or benefits to using combined hormonal contraception (pill, patch or ring) continuously to stop or reduce periods? (JLA PSP Priority 7)
Overall ranking 7
JLA question ID 0049/7
Explanatory note There are 7.2 million prescriptions for oral contraception in England (NHS 2013-14) or which about 2/3 are for the combined pill. A recognised benefit of combined hormonal contraception is that it lightens periods and it is a treatment option for women with painful periods. The systematic review reported that bleeding patterns improved in many studies using extended cycles but satisfaction and discontinuation rates were similar. Further RCTs comparing different regimes using standard outcome measures could help provide evidence on short term effects. Cohort studies are needed to evaluate the long term effects of using this method (see priority 3).

Continuous or extended cycle vs. cyclic use of combined hormonal contraceptives for contraception. Alison Edelman, Elizabeth Micks, Maria F Gallo, Jeffrey T Jensen, David A Grimes. July 2014

Health Research Classification System category Reproductive Health and Childbirth
Extra information provided by this PSP
Original uncertainty examples

“Although the pill was primarially developed as a contraceptive, why aren't we talking about the benefits it can bring? “ (patient),  ~  The affects of 'back to back' pill packets  (both)

Submitted by Healthcare Professionals x 0~Patients x 5~Both x 3
PSP information
PSP unique ID 0049
PSP name Contraception
Total number of uncertainties identified by this PSP. 57  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 21 April 2017