Effectiveness, safety and acceptability of continuous or extended-cycle use of combined oral contraceptives (COCs): a systematic review and meta-analysis.

BMJ Sex Reprod HealthSep 23, 2026 (epub)
Clinical ResearchObstetrics & Gynecology

Li Jiang, Maya Kshatriya, Zulfiqar A Bhutta et al.

✦ AI-curated · Sources linked

In 30 seconds

This systematic review and meta-analysis evaluated the effectiveness, safety, and acceptability of continuous or extended-cycle combined oral contraceptives (COCs) compared to conventional cyclic regimens. The analysis included 18 randomized controlled trials. Continuous or extended-cycle COCs showed similar contraceptive effectiveness to cyclic COCs, with an odds ratio for unintended pregnancies of 0.79.

Key findings

  • Continuous or extended-cycle COCs had similar contraceptive effectiveness to cyclic COCs (OR 0.79).
  • Users experienced fewer total bleeding days but more unscheduled bleeding.
  • No significant difference in adverse events was found (OR 1.20).
  • The risk of deep vein thrombosis was low, with an approximate increase of 0.7 cases per 1000 users.

Why it matters

Understanding the effectiveness and safety of different COC regimens is crucial for clinicians to provide informed contraceptive options to patients, particularly regarding bleeding patterns and adverse events.

Source

PubMed · PMID 42778302

Published in BMJ Sex Reprod Health. This summary was written by xxcode from the publication's abstract and metadata. It is not peer reviewed and is not a substitute for the original article. For clinical decisions, review the original publication.

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