ABSTRACT
OBJECTIVE: To test the hypothesis that extending the number of consecutive active oral contraceptives (OC)s given will decrease the frequency of menstrual-related problems including dysmenorrhea, menorrhagia, premenstrual-type symptoms, and menstrual migraines. METHODS: A prospective analysis was designed to track the experiences of 50 women taking OCs and experiencing menstrual-related problems. Fifty consecutive patients, who were taking OCs and had symptoms during the pill-free interval, were followed in a multispecialty clinic by an individual physician and nurse practitioner team. The patients were permitted to extend the number of consecutive active OCs to delay menstrual-related symptoms. RESULTS: Immediate outcome of the 50 patients revealed 74% (37 patients) stabilized on an extended regimen of 6 to 12 weeks of consecutive days with active OCs. Twenty-six percent (13 patients) either discontinued OCs or returned to the standard regimen with 3 weeks of active pills. Of the 37 patients who were stabilized on an extended regimen, 27 have completed thus far between five and 13 extended cycles with 6-23 months of follow-up (mean 16 months). CONCLUSIONS: Experience in a series of 50 OC users with menstrual-related symptoms demonstrated that delaying menses by extending the number of consecutive days of active pills is well tolerated and efficacious. We believe that a large prospective study is warranted to further our knowledge in this area.
Subject(s)
Contraceptives, Oral/administration & dosage , Menstruation Disturbances/prevention & control , Substance Withdrawal Syndrome/prevention & control , Adult , Contraceptives, Oral/adverse effects , Female , Follow-Up Studies , Humans , Menstruation Disturbances/chemically induced , Middle Aged , Prospective Studies , Substance Withdrawal Syndrome/etiology , Time FactorsABSTRACT
Both the number of motile spermatozoa inseminated and the site of insemination have been correlated with the probability of pregnancy in patients inseminated with donor sperm cells from fertile men. Nevertheless, more data on the minimum sperm dose required to achieve a pregnancy are needed to understand this apparent relationship. We analyzed retrospectively 2280 cycles of intrauterine insemination to test the hypothesis that intrauterine insemination requires a minimum number of motile sperm cells to maximize the pregnancy rate. Our analysis of 1761 cycles of intrauterine insemination using from 200,000 to more than 200 million motile sperm cells showed no significant relationship between sperm dose and pregnancy rate.