Re: Continuous OCP
From: Dr. Ainsworth (ainsron@sbcglobal.net)
Tue May 24 17:01:39 2005
Based on what data?? According to the prescribing information online at
the NuvaRing website the data only goes out to 4wks, i.e. 28 days. Most
months are 30-31d:
Prolonged use of NuvaRing®
If NuvaRing® has been left in place for up to one extra week (i.e., up
to four weeks total), it should be removed and the patient should insert
a new ring after the one-week ring-free interval. The mean serum
etonogestrel concentration during the fourth week of continuous use of
NuvaRing® was 1272 ± 311 pg/mL compared to a mean concentration range of
1578 ± 408 to 1374 ± 328 pg/mL during weeks one to three. The mean
serum ethinyl estradiol concentration during the fourth week of
continuous use of NuvaRing® was 16.8 ± 4.6 pg/mL compared to a mean
concentration range of 19.1 ± 4.5 to 17.6 ± 4.3 pg/mL during weeks one
to three. If NuvaRing® has been left in place for longer than four
weeks, pregnancy should be ruled out, and an additional method of
contraception, such as male condoms or spermicide, must be used until a
new NuvaRing® has been used continuously for seven days.
At Tue, 24 May 2005, Richard Chudacoff, MD wrote:
>
>Nope...35 days of continuous hormone uptake. My patients tend to put it in
>on the first of the month, and take it out on the 25th (if they want a
>cycle) or replace it each month on the first, if they do not want a cycle.
>Or they have the option of determining how many cycles they want. Might as
>well benefit from the two extra weeks of coverage
>
>--
>Richard Chudacoff, MD
>
>This message is confidential, intended only for the named recipient(s) and
>may contain information that is privileged or exempt from disclosure under
>applicable law. If you are not the intended recipient(s), you are notified
>that the dissemination, distribution or copying of the messages is strictly
>prohibited. If you receive this message in error, or are not the named
>recipient(s), please notify the sender at either the e-mail address or
>telephone number above and delete this e-mail from your computer.
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of ainsron
>Sent: Tuesday, May 24, 2005 3:18 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Continuous OCP
>
>Why? Are you sure you can wear it for four weeks consecutively and still be
>effective? The normal sequence is just like OCPs, 3wks on/1wk off.
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Richard
>Chudacoff, MD
>Sent: Tuesday, May 24, 2005 11:06 AM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Continuous OCP
>
>One thought though. If you use a conventional pack of pills, you need 18
>packs a year for continuous amenorrhea. With NuvaRing, you only need 12. If
>a patient is paying the difference, it can be quite a lot of cash.
>
>Richard Chudacoff, MD
>
>This message is confidential, intended only for the named recipient(s) and
>may contain information that is privileged or exempt from disclosure under
>applicable law. If you are not the intended recipient(s), you are notified
>that the dissemination, distribution or copying of the messages is strictly
>prohibited. If you receive this message in error, or are not the named
>recipient(s), please notify the sender at either the e-mail address or
>telephone number above and delete this e-mail from your computer.
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Joanne
>Bulley, MD
>Sent: Monday, May 23, 2005 6:56 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Continuous OCP
>
>Great - this is what I usually do -- tell them to gradually lenghthen
>the cycle. Must be that Great Minds Think Alike.
>
>Joanne
>
>At Fri, 20 May 2005, Lynn D. Montgomery, M.D. wrote:
>>
>>I agree with Rich, the studies have shown that you have to gradually
>>increase, starting with regular cycling, then go two months, then three and
>>so on. If you don't, there is a tendency to have an increased incidence of
>>unscheduled bleeding. I use Lo-Ovral - steady hormone levels and good
>>progestational agent.
>>Lynn
>>
>>--
>>Lynn D. Montgomery, M.D.
>>Maternal-Fetal Medicine, OB/GYN
>>Rocky Mountain Women's Health
>>2835 Fort Missoula Rd., Suite 304
>>Missoula, Montana, 59804
>>406-549-0978
>>fax 406-549-0987
>>e-mail: apgar10@montanadsl.net
>>
>> _____
>>
>--
>Joanne Bulley, MD
>Keene, NH, USA
>
|
|
