Johns Hopkins Bloomberg School of Public Health: The INFO Project

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Dr. Jim Shelton's Pearls "Pearl" for the week of September 12, 2003

Seasonale

What can you tell me about the new "extended regimen" oral contraceptive - "Seasonale" recently approved by the USFDA?

As discussed in previous "Pearls" there is nothing magic about the standard 21day active/ 7 day placebo OC regimen. Continuing to take active pills postpones withdrawal bleeding. For years many women have taken active pills beyond the 21 to postpone bleeding. The makers of Seasonale have simply packaged 84 active daily pills, followed by 7 placebo pills.

The contraceptive hormones in Seasonale (levonorgestrel and ethinyl estradiol) are commonly used. In fact the Seasonale pills are pharmacologically the same as the OC USAID commonly supplies - Lo-Femenal.

While Seasonale is designed to avoid bleeding, a recent randomized clinical trial found that breakthrough bleeding/spotting was more common in the first 84 day cycle than with conventional OCs. However, by the 4th extended cycle such bleeding was "comparable" to conventional OCs.

Overall continuation with conventional Seasonale was a bit worse in the trial than with conventional OCs, perhaps reflecting the more frequent breakthrough bleeding. Still I do see some value in having this choice available particularly for women wishing to reduce symptoms associated with monthly menstruation.

References:

1. Anderson FD, Hait H, et al. A multicenter, randomized study of an extended cycle oral contraceptive. Contraception 2003; 68:89-96.

The "Pearls" offer answers to commonly asked questions about family planning. These "Pearls" are prepared by Dr. James D. Shelton, Senior Medical Scientist, Office of Population, United States Agency for International Development (USAID)

Disclaimer: The information provided on this web site is not official U.S. Government information and does not represent the views or positions of the U.S. Agency for International Development, the U.S. Government or The Johns Hopkins University.