Evidence map›Paper›PMID 40164172›Full record

ArticleJMIR research protocols2025

Effects of a Monophasic Hormonal Contraceptive With Norgestimate+Ethinyl Estradiol on Menstrual Bleeding: Protocol and Design of a Multicenter, Prospective, Open-Label, Noncomparative Study in Italy.

Angelo Cagnacci, Giovanni Grandi, Giampiero Capobianco, Anna Maria Fulghesu, Giuseppe Morgante, Vincenzo Biondelli, Elena Piccolo, Elena Casolati, Mario Mangrella

Registry-linked trialAbstract readClinical Trial Protocol
In one paragraph

Article in JMIR research protocols, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06067256 (A Multicentre, Prospective, Open-label, Non-comparative Study to Evaluate Menstrual Bleeding Typology, Tolerability, and Compliance During a Monophasic Hormonal Contraceptive Treatment With Norgestimate + Ethinylestradiol in Italy.), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06067256 phase4unknown statusnot on this map

A Multicentre, Prospective, Open-label, Non-comparative Study to Evaluate Menstrual Bleeding Typology, Tolerability, and Compliance During a Monophasic Hormonal Contraceptive Treatment With Norgestimate + Ethinylestradiol in Italy.

TypeinterventionalSponsorItalfarmacoRan2023 to 2024Enrolled228ConditionsContraceptionArmsFemale Contraceptive
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Angelo CagnacciDipartimento di Neuroscienze, Riabilitazione, Oftalmologia e Scienze Materno Infantili, Istituto di Recerca e di Cura e Carattere Scientifico (IRCSS)-Ospedale San Martino, Genoa, Italy.ORCID 0000-0003-2714-623X
Giovanni GrandiDipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell'Adulto, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.ORCID 0000-0002-3567-3278
Giampiero CapobiancoDipartimento di Scienze Mediche, Chirurgiche e Sperimentali, Università degli Studi-Azienda Ospedaliero Universitaria di Sassari, Sassari, Italy.ORCID 0000-0002-5523-8943
Anna Maria FulghesuDipartimento di Scienze Chirurgiche, Policlinico Universitario Monserrato Duilio Casula, Monserrato, Italy.ORCID 0000-0001-8116-3968
Giuseppe MorganteDipartimento della Mamma e dei Bambini, Unità Operativa Semplice Procreazione Medicalmente Assistita del Policlinico Le Scotte, Siena, Italy.ORCID 0000-0001-5024-2321
Vincenzo BiondelliUnità Operativa Ostetricia e Ginecologia, Ospedale San Pio da Pietrelcina, Vasto, Italy.ORCID 0009-0005-1403-0985
Elena PiccoloMedical Affairs Department, Italfarmaco SpA, Milan, Italy.ORCID 0009-0000-8819-2876
Elena CasolatiPrivate Practice of Obstetrics and Gynecology, Milan, Italy.ORCID 0000-0001-6013-4957
Mario MangrellaMedical Affairs Department, Italfarmaco SpA, Milan, Italy.ORCID 0000-0001-7153-9191

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNorgestimate (NGM) is a progestin with negligible androgenic activity that is available in combination with ethinyl estradiol (EE) as a monophasic combined oral contraceptive (COC). It has been more than 30 years since a clinical study evaluated the effects of monophasic NGM/EE on menstrual cycle characteristics in healthy women, and in the interim, there has been growing recognition that clinical trials of contraceptives should evaluate a wide range of potential positive and negative impacts for users.

objectiveThe aim of this study is to investigate menstrual cycle control during the use of a monophasic COC formulation containing NGM 0.25 mg and EE 0.035 mg (Effimia; Italfarmaco SpA), using established methodologies as well as patient-reported outcomes.

methodsThis is a prospective observational study being undertaken in a target population of 228 healthy Italian women aged 18-35 years who are starting oral contraception for the first time or switching from another COC. The participants are asked to complete a diary for 6 cycles recording information about their menstrual cycles (frequency, duration, regularity, estimated flow volume, and breakthrough bleeding), any unscheduled bleeding, and an evaluation of dysmenorrhea, using a 100-mm visual analog scale from 0=no pain to 100=very severe pain, and any adverse events. Compliance is assessed after 3 and 6 months via returned medication. The primary end point is the change from baseline in the rate of intermenstrual bleeding during the sixth cycle. At baseline, 3 months, and 6 months, acne will also be assessed using the Global Acne Grading Scale, and participants will complete a Profile of Mood State to assess premenstrual syndrome and the Female Sexual Function Index to evaluate the quality of their sex life. A subgroup of 28 participants at 1 site (Genoa) is also providing a blood sample for the assessment of metabolic, endocrine, and coagulation parameters.

resultsStudy enrollment began in July 2023 and is expected to be complete by December 2024. Data analysis is expected to be complete by October 2025.

conclusionsThis study into the effects of monophasic NGM/EE 0.25/0.035 mg on menstrual characteristics in healthy Italian women will provide up-to-date data on these effects and includes assessments of a range of other parameters, such as acne severity and patient-reported outcomes, in line with recent international consensus recommendations.

trial registrationClinicalTrials.gov NCT06067256; https://clinicaltrials.gov/study/NCT06067256 and EudraCT 2021-003027-15; https://www.clinicaltrialsregister.eu/ctr-search/trial/2021-003027-15/IT. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/63683.

Indexed as

Contraceptives, Oral, CombinedEthinyl EstradiolMenstruationNorgestrelAdolescentAdultClinical Trials, Phase IV as TopicDrug CombinationsFemaleHumansItalyMenstrual CycleMulticenter Studies as TopicProspective StudiesYoung AdultContraceptives, Oral, CombinedDrug CombinationsEthinyl EstradiolnorgestimateNorgestrelassessmentcombined oral contraceptivedata analysisethinyl estradiolhormonal contraceptiveItalymenstrual cyclemenstrual healthmethodologymonophasicnorgestimateobservational studypatient-reported outcomesreproductive healthwomen’s health

Identifiers

PMID40164172
PMCPMC11997520

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.