Combined hormonal contraceptives (pill, patch, ring) can be taken in extended regimens without taking the hormone-free intervals. There is a risk of breakthrough bleeding. It is suggested to stop hormonal pills for about 5 days when breakthrough bleeding occurs. About 70% of women become amenorrheic after one year of use. (35)
In patients with malignancy, estrogen contained in combined hormonal contraceptives increases the risk of deep venous thrombosis and pulmonary embolism. In addition, it is important to consider that some patients might experience nausea and emesis during the course of their treatment and patient might not be able to tolerate them. Other drugs or medication might alter serum level of the given combined hormonal contraceptive.