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ARHP/NPWH Clinician Survey: Choosing When to Menstruate: The Role of Extended Contraception

ARHP and NPWH Annual Meetings' Registrant Survey
August–September 2002

The Association of Reproductive Health Professionals (ARHP) and the National Association of Nurse Practitioners in Women's Health (NPWH) recently surveyed their annual meeting registrants to determine their understanding of appropriate uses of and counseling for extended regimen. The total number of respondents was 117.

Do your patients ask you about extended regimens of oral contraception?

Sixty-five percent of respondents indicate their patients do ask about extended regimens of oral contraceptives

Do you prescribe extended regimens of oral contraception for any of your patients?

Seventy-seven percent of respondents prescribe extended regimens of oral contraceptives

Approximately what percentage of the OC prescriptions you write are for an extended regimen?

0% 2%
Fewer than 5% 0%
5 - 20% 27%
20 - 35% 7%
35 - 50% 0%
I cannot provide an estimate 64%

When you prescribe an extended regimen, do you prescribe (check all that apply)

More than 21 active pills per cycleand a shortened pill-free interval 15%
42 active pills followed by a 7-day pill-free interval 29%
63 active pills followed by a 7-day pill-free interval 72%
Active pill with instructions for the patient to take a 7-day pill-free interval if they experience spotting with continued use 35%

Other

  • Contiunous active pills (4)
  • 6 months (2)
  • 2-7 pill-free days if any breakthrough bleeding
  • 84 days (2)

 

12%

What factors affect your decision to prescribe extended regimens (please check all that apply):

Patient request 79%
Lifestyle (offering to patients for avoiding menses for non-therapeutic reasons) 78%
Therapeutic reasons (please check all that apply)  

Endometriosis

83%

Dysmenorrhea

73%

Menorrhagia

73%

Twenty-eight percent of our respondents indicate they DO NOT prescribe extended regimen oral contraceptives

Not licensed to prescribe 26%
Extended regimen is not part of the approved class labeling for oral contraceptives 4%
My patients have not requested extended regimen 43%
Insurance coverage 4%
Requires extra counseling with patients to correctly follow regimen 4%
Safety considerations (please check all that apply)

Endometrial hyperplasia/cancer with extended regimens

0%

Increased exposure to hormones

0%

Limited data on use of extended regimen

4%

Need for regular withdrawal bleeding

0%
Not providing direct patient care 17%
No answer Provided 4%