Ultra-low dose ethinyl estradiol 20 ug/desogestrel 120 ug
Ethinyl estradiol 20 ug/NETA 1 mg
‘Step-up/step-down’ (multiphasic): Estradiol valerate(E2V) 3 mg on days one to two; E2V 2 mg + DNG 2 mg on days three to seven; E2V 2 mg + DNG 3 mg on days eight to 24; E2V 1 mg on days 25 to 26; and placebo on days 27 to 28
Comparing OCPs to placebo (2 studies both used multiphasic regimen) there was
Improved response to treatment (return to menstrual ‘normality’)
Odds ratio (OR) 22.12 (95% CI 4.40 to 111.12; moderate-quality evidence)
OR 5.15 (95% CI 3.16 to 8.40; moderate-quality evidence)
More minor adverse events, especially breast pain
Comparing OCPs to NSAIDs (Mefenamic acid | Naproxen)
Insufficient evidence to determine reduction in MBL
Comparing OCPs to LNG-IUS
LNG-IUS was more effective in reducing MBL
OR 0.21 (95% CI 0.09 to 0.48; low-quality evidence)
Comparing vaginal ring to the following
OCPs: No evidence of a benefit for one treatment compared to the other, with greater likelihood of nausea with OCPs
Progestogens: Vaginal ring may increase odds of satisfaction but not clear if there is benefit in MBL reduction (small ‘n’)
Combined OCPs were effective over 6 months in reducing HMB
LNG-IUS is more effective than OCP for reducing HMB
Data limited regarding comparisons with vaginal ring, NSAIDs and long acting progestogens
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