However, results from the study also indicate greater breakthrough bleeding, or spotting, among women in the continuous group. Legro says that while greater breakthrough bleeding may be a truly objectionable side effect for many women, it does not seem to affect their quality of life.
"That is one of the unique things of this study. The quality of life did not necessarily decrease as it was counterbalanced by improvements in other areas such as pain and mood swings," the Penn State researcher added.
According to Legro, the study suggests that there may be diverse mechanisms of breakthrough bleeding depending on whether a woman is using either a cyclical or continuous regimen of birth control pills.
In the case of cyclic pills, the ovary comes back into the equation during the pill free interval leading to a rebound increased secretion of ovarian hormones, which in turn contributes to some breakthrough bleeding, he explained.
"Breakthrough bleeding in the continuous group, in our opinion, is most likely due to the fact that the pill does too good of a job in suppressing the ovary and the lining of the uterus gets a little bit thin and fragile so that from time to time there is a little bit of bleeding," added Legro, whose work is funded by the National Institutes of Health.
The study provides a physical reason for continuous oral contraceptive pills to treat such chronic medical conditions such as polycystic ovary syndrome, endometriosis and premenstrual syndrome, where additional suppression of the ovary or the endometrium is desired, and Legro noted that other chronic conditions such as hypertension or diabetes are treated continuously, not three weeks out of four. Further stu
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