Effect of Multivitamins on Continuation Rate and Side Effects of Combined Oral Contraceptives: A Randomized Controlled

Abstract

Abstract: Background: Combined oral contraceptives (COCs) are among the most common contraceptive methods used worldwide. They are highly effective if used consistently and correctly, but their failure rat with typical use is much higher. Incorrect and inconsistent use of COCs is one of the most common pregnancy and the main reasons of discontinuations are due to side effects or health concerns. Therefore, this study aimed to assess the effect of taking multivitamins during pill-free periods on reducing COC side effects and increasing the continuation rate (primary outcomes) within the first six eyeless of use, user satisfaction rate was also assessed. Methods: in this trial. 330 women referring to public health centers of a in Iran for starting to use 21- packs pills (each pill contains 0.15 mg levenorgestrel and0.03 mg ethanol - estradiol) were randomly allocated into three groups; receiving 42-pills multivitamins, 42- pills placebo or no pills for using for using one pill a day during the 7-days pill-free period between 21-COC packs for 6 months. The groups were compared using cox regression and Chi-squire tests. Results: there were no losses to follow- up. One, three and Six-month continuation rate for the groups was 100%, 92.7% and 88.2% for multivitamins, 98.2%, 89.9% and 75.2% for placebo and 97.3%, 85.0% and 67.3% for no intervention groups, respectively, nausea, weight gain, mood changes, and breast tenderness was significantly less common in the multivitamins group than the placebo and no intervention groups at most of the 2,3 and 6 month follow-up and spotting only in 2 and 3 month follow-up was significantly less common in the multivitamins group than the placebo and no intervention groups. Conclusions: multivitamins for the first sixth month of using COCs could decrease its side- effects and improve continuation rate. More studies are needed to generalize the results to effects and improve continuation rate .more studies are needed generalize the resells to other setting, especially those with rich nutrient communities.