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Review: 6 RCTs show similar efficacy and safety for continuous dosing and 28 day combination contraceptive pills

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 Q Are continuous (extended) combination oral contraceptives (COCs) as effective and safe as monthly cyclic COCs?

Clinical impact ratings GP/FP/Primary care ★★★★★★☆ Gynaecology ★★★★★★☆


Embedded ImageData sources:

Medline, EMBASE/Excerpta Medica, Cochrane Central Register of Controlled Trials, POPLINE, reference lists, and corresponding authors of studies.

Embedded ImageStudy selection and assessment:

randomised controlled trials (RCTs) comparing continuous or extended cycle COCs (>28 d of active pills) with traditional dosing (21 d of active pills) in women of reproductive age. Exclusion criteria: COCs for treating such conditions as endometriosis. Study quality was assessed.

Embedded ImageOutcomes:

bleeding patterns, participant satisfaction, pregnancy, study discontinuation, and adverse events.


6 RCTs met the selection criteria. RCTs were not combined in a meta-analysis because of differences in type of COC, time of exposure, and definitions …

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  • For correspondence: Dr A Edelman, Oregon Health & Science University, Portland, OR, USA. edelmana{at}

  • Sources of funding: US Agency for International Development and National Institute of Child Health and Human Development.