Menstrual Bleeding with Continuous Use of Combined Oral Contraceptive Pills or Vaginal Ring

Women who choose continuous hormonal contraceptive regimens with the expectation of having “no periods” might stop because of unpredictable bleeding patterns. In this industry-supported Australian study, researchers compared bleeding patterns with 12 months' continuous use of combined oral contraceptive pills (COCs; 0.02 mg ethinyl estradiol and 0.1 mg levonorgestrel) or the contraceptive vaginal ring (CVR; 0.015 mg ethinyl estradiol and 0.15 mg etonogestrel released daily).

Of 66 women randomized to each group (age range, 18–45, primarily white, nulliparous, and educated), 46 COC users and 47 CVR users completed 12 months of their regimens. Mean total number of bleeding or spotting days was statistically similar for each method and decrease…