Abstract
BACKGROUND Combined oral contraceptive pills are the most effective temporary contraception methods and are used by approximately 60 - 80 million eligible women throughout the world. It is the oestrogen component of the combined oral contraceptive (COC) which is responsible for the undesirable and serious side effects such as deep vein thrombosis (DVT) and pulmonary embolism (PE). So, there has been a constant effort to reduce the amount of ethinyl estradiol (EE) while maintaining its contraceptive efficacy. This study was aimed at studying the safety and efficacy of ultralow dose combined oral contraceptive (containing 15 mcg EE + 60 mcg gestodene) in rural Indian women. METHODS The study was done at Rama Medical College, Mandhana, Kanpur, among 70 patients who fulfilled the inclusion criteria. The patients were given ULDOCP and followed up for 6 months. The patients followed the regime of one tablet of ULDOCP daily from day 1 to day 24 of the menstrual cycle with 4 days pill free period before starting the next pack. RESULTS Seventy patients completed the study till 3 months and fifty patients completed the study till 6 months. Break through bleeding (BTB) was the only prominent side effect which was reduced in subsequent cycles and our patients tolerated this well. No pregnancy resulted. The ULDCOP was very well accepted by those women who were counselled about possible side effects and their harmless nature before starting the study. It was found that the users were satisfied with the use of ULDOCP. All side effects were significantly lower after 2 months of use and there were no serious side effects. CONCLUSIONS The 24 / 4 ULDOCP regimen seems to be a safe and effective contraceptive method for use in rural population after properly counselling them. The reduced pill free interval of 4 days offered additional advantages. KEYWORDS Ultra-Low Dose Oral Contraceptive Pills (ULDOCP), Ethinyl Estradiol (EE), Safe Contraception, Gestodene, BTB (Break Through Bleeding)
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