20 mcg versus >20 mcg estrogen combined oral contraceptives for contraception

20 µg versus >20 µg estrogen combined oral contraceptives for contraception

A systematic review was undertaken (1) and found that:

• no differences were found in contraceptive effectiveness for 20 µg versus >20 µg estrogen combined oral contraceptives
  
  
• compared to the higher-estrogen pills, several COCs containing 20 µg ethinyl estradiol (EE) resulted in higher rates of early trial discontinuation (overall and due to adverse events such as irregular bleeding) as well as increased risk of bleeding disturbances (both amenorrhea or infrequent bleeding and irregular, prolonged, frequent bleeding, or breakthrough bleeding or spotting)
  • cycle control may be better with COCs containing 30-35 µg EE compared with those containing 20 µg

Reference:

1. Gallo MF, Nanda K, Grimes DA, Lopez LM, Schulz KF. 20 µg versus > 20 µg estrogen combined oral contraceptives for con- traception. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD003989. DOI: 10.1002/14651858.C D003989.