Contraceptive compliance with a triphasic and a monophasic norethindrone-containing oral contraceptive pill in a private adolescent practice

Abstract

Study Objective: This study was undertaken to assess the impact of a monophasic and triphasic norethin-drone-containing oral contraceptive pill on reported side effects and compliance.

Design: Adolescents initiating oral contraceptive use were studied at baseline, 3 months and 12 months, to determine compliance and side effects associated with the use of two oral contraceptive pills.

Setting: A suburban private practice of adolescent medicine.

Participants: Ninety-nine sexually active adolescent and young adult women were sequentially entered into the study (49 initiating a monophasic pill and 50 a triphasic pill).

Outcome Measurements: Compliance with oral contraceptive use at 3 and 12 months was determined for adolescents and young adult women initiating the use of two oral contraceptive pills. Demographic data, sexual history, career goals, and concerns about use were collected before use. Compliance and side effects experienced were determined at 3 and 12 months.

Results: There was no significant difference in compliance in the use of the two oral contraceptives at 3 and 12 months of follow-up. At 3 months, there was no difference in reported side effects, but at 12 months, patients taking the triphasic norethindrone pill were more likely to experience breakthrough bleeding than those taking the monophasic pill (p = 0.001) and to change pills. Despite the common fear among adolescents of weight gain associated with oral contraceptive pill use, mean weight change at 3 months was not different between the two pills and was 0.59 and 0.55 kg for the monophasic and triphasic pill at 3 months and 1.00 kg and 1.24 kg for the monophasic and triphasic pills at 12 months. “Perceived” rather than actual weight gain led to discontinuation of the pill.

Conclusion: Adolescents experienced more side effects on the triphasic than the monophasic norethindrone-containing pill but compliance was the same. Weight issues and breakthrough bleeding need to be addressed in suburban practices.