{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:03:00Z","timestamp":1761058980879,"version":"3.44.0"},"reference-count":37,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Fam Plann Reprod Health Care"],"accepted":{"date-parts":[[2009,9,1]]},"published-print":{"date-parts":[[2009,10]]},"abstract":"<jats:p>Combined oral contraceptives (COCs) are highly effective when correctly used but unscheduled bleeding, which occurs fairly commonly during the early months, is disruptive for many women. The mechanisms underlying this bleeding are not fully understood. Several studies have shown that extended-cycle or continuous-use COCs are typically associated with higher initial rates of unscheduled bleeding than are conventional 21-day cyclical COCs. Some medicines, herbal supplements and smoking may increase unscheduled bleeding by interfering with estrogen metabolism. The most common cause of unscheduled bleeding is non-adherence to a prescribed COC regimen. Compliance can be improved by appropriate counselling of women about the possibility of unscheduled bleeding and the importance of adherence to the pill regimen. If abnormal bleeding persists beyond 3\u20134 months and causes such as incorrect usage can be ruled out, other causes should be considered.<\/jats:p>","DOI":"10.1783\/147118909789587411","type":"journal-article","created":{"date-parts":[[2009,10,10]],"date-time":"2009-10-10T15:39:05Z","timestamp":1255189145000},"page":"245-248","source":"Crossref","is-referenced-by-count":5,"title":["Unscheduled bleeding in combined oral contraceptive users: focus on extended-cycle and continuous-use regimens"],"prefix":"10.1136","volume":"35","author":[{"given":"Martha","family":"Hickey","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sweta","family":"Agarwal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2009,10,1]]},"reference":[{"key":"ref_1","first-page":"1","article-title":"Hum Reprod Update","volume":"14","year":"2007","unstructured":"Hum Reprod Update 2007; 14: 1\u201311."},{"key":"ref_2","first-page":"185","article-title":"Breakthrough bleeding number one problem with OC use","volume":"12","year":"1991","unstructured":"Breakthrough bleeding number one problem with OC use. 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All too often, reviewing articles reveals that the authors have not stated the message they wish to convey. If they don\u2019t know, how will their readers? Many articles arrive at a journal clearly originally intended for another or without having consulted the authors\u2019 instructions \u2013 another \u2018must\u2019 Tim Albert outlines. Clarity of thought and writing is helped by looking at the following suggested questions: Why did we start? What did we do? What did we find? What does it all mean?","article-title":"Throughout the author points out that writing is not a difficult process, but should be regarded as producing a good product and marketing it well. If only more authors followed Tim Albert\u2019s advice about setting their brief out clearly before starting writing! The brief he recommends contains five steps: the message, the market, the length, the deadline and the co-authors. All too often, reviewing articles reveals that the authors have not stated the message they wish to convey. If they don\u2019t know, how will their readers? Many articles arrive at a journal clearly originally intended for another or without having consulted the authors\u2019 instructions \u2013 another \u2018must\u2019 Tim Albert outlines. Clarity of thought and writing is helped by looking at the following suggested questions: Why did we start? What did we do? What did we find?"}],"container-title":["Journal of Family Planning and Reproductive Health Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1783\/147118909789587411","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T19:07:48Z","timestamp":1757099268000},"score":1,"resource":{"primary":{"URL":"https:\/\/jfprhc.bmj.com\/lookup\/doi\/10.1783\/147118909789587411"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,10]]},"references-count":37,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2009,10,1]]},"published-print":{"date-parts":[[2009,10]]}},"alternative-id":["10.1783\/147118909789587411"],"URL":"https:\/\/doi.org\/10.1783\/147118909789587411","relation":{},"ISSN":["1471-1893","2045-2098"],"issn-type":[{"type":"print","value":"1471-1893"},{"type":"electronic","value":"2045-2098"}],"subject":[],"published":{"date-parts":[[2009,10]]}}}