Effects of a combined oral contraceptive containing oestradiol valerate/dienogest on hormone withdrawal-associated symptoms: results from the multicentre, randomised, double-blind, active-controlled HARMONY II study

G Macìas, Gabriela Rodríguez Macias, Gabriele S. Merki‐Feld, G S Merki-Feld, S Parke, Susanne Parke, Uwe Mellinger, U Mellinger, Marco Serrani, M Serrani
Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology · 2013 · vol. 33(6) , pp. 591–596 · doi:10.3109/01443615.2013.800851 · PMID:23919857 · W2144263581
RCT OA: closed CC0 ⤵ 17 in-corpus citations
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The HARMONY II study found that a combined oral contraceptive with estradiol valerate/dienogest reduced hormone withdrawal-associated headaches and pelvic pain more effectively than ethinylestradiol/levonorgestrel.

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Abstract

The objective of this multicentre, randomised, double-blind study was to compare a combined oral contraceptive (COC) containing oestradiol valerate/dienogest (E2V/DNG) administered in a dynamic dosing regimen with a monophasic COC containing ethinyloestradiol/levonorgestrel (EE/LNG), with regard to their ability to reduce the frequency and intensity of headache and pelvic pain in women with hormone withdrawal-associated symptoms (HWAS). Women aged 18-50 years received E2V/DNG in an oestrogen step-down and progestin step-up regimen (26/2 regimen; n = 223) or EE 20 μg/LNG 100 μg (21/7 regimen; n = 218) over six cycles. Headache and pelvic pain were assessed using a visual analogue scale (VAS) during cycle days 22-28. Rescue medication use was also assessed. E2V/DNG was superior to EE/LNG with regard to reducing the frequency and intensity of headache and pelvic pain from baseline to cycle 6 (change from baseline in the average of the three highest VAS values [mean ± standard deviation]: 47.7 ± 29.4 vs 34.5 ± 25.7 mm, respectively; p < 0.0001). The use of rescue medication was also significantly reduced with E2V/DNG compared with EE/LNG (p < 0.05). E2V/DNG may be a good option for women who experience HWAS with traditional 21/7-day regimen COCs.

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Outcome instruments

VAS-pain

MeSH descriptors

Contraceptives, Oral, Combined Estradiol Nandrolone Substance Withdrawal Syndrome Adult Contraceptives, Oral, Combined Contraceptives, Oral, Combined Double-Blind Method Estradiol Estradiol Ethinyl Estradiol Ethinyl Estradiol Female Headache Headache Headache Humans Levonorgestrel Levonorgestrel Nandrolone

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