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Strategies to diminish unscheduled bleeding with low-dose combined oral contraceptives continue to be explored. In a manufacturer-funded study involving 1864 women (age range, 18–45), investigators evaluated use of 20-μg ethinylestradiol plus 3-mg drospirenone in a conventional regimen (24 days active pills, 4 days hormone-free) or one of two flexible regimens.
All participants began by taking active pills for 24 days. Women in the first flexible dosing group (management of intracyclic bleeding [MIB]) then continued to take pills until 3 consecutive days of bleeding or spotting occurred, after which they initiated a 4-day, hormone-free break to elicit withdrawal bleeding. Women assigned to the second flexible regimen (active period control […