section name header

Evidence summaries

Triphasic Versus Monophasic Oral Contraceptives for Contraception

Triphasic OCs appear to have similar contraceptive effectiveness as monophasic OCs but the evidence is insufficient to determine any differences in bleeding patterns or discontinuation rates. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 23 trials. The triphasic and monophasic preparations did not differ significantly in contraceptive effectiveness (19 trials). Several trials reported favorable bleeding patterns (i.e. less spotting, breakthrough bleeding or amenorrhea) in triphasic vs monophasic OC users. However, meta-analysis was generally not possible due to differences in measuring and reporting the cycle disturbance data as well as differences in progestogen type and hormone dosages. The discontinuation rates due to medical reasons, cycle disturbances, intermenstrual bleeding or adverse events did not differ.

Authors' conclusions: Given the often higher cost and greater complexity of triphasic-pill regimens, monophasic pills should be the first choice in oral contraceptives.

Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in interventions and outcomes).

References

  • Van Vliet HA, Grimes DA, Lopez LM et al. Triphasic versus monophasic oral contraceptives for contraception. Cochrane Database Syst Rev 2011;(11):CD003553. [PubMed]

Primary/Secondary Keywords