Low-dose oral contraceptive to re-induce menstrual bleeding in amenorrheic women on DMPA treatment: A randomized clinical trial

Abstract

Background: Depot medroxyprogesterone acetate (DMPA), a long-acting contraceptive, has many advantages over other hormonal contraceptives. However, its major discontinuance reason is bleeding disorders. Our aim was to study bleeding complications of DMPA when used as a contraceptive in the Ardabil district and a clinical trial of low-dose oral contraceptive (LD-OC) pills in controlling these complications. Material/Methods: All 917 women referred to Ardabil's health centers to have a DMPA injection for the first time were entered into a longitudinal study. Those complaining of menstrual cessation were entered into a double-blinded randomized clinical trial. Data were collected by means of nine questionnaires, seven of which were used for descriptive purposes and two for clinical trial study. The data were analyzed with the SPSS statistical package. Results: Those DMPA users with a cesarean section history had a higher chance of bleeding complications. Four hundred forty-four of the 917 women receiving the injection discontinued using it before the end of the study period. The main reason for discontinuation (in 70) was irregular menstrual bleedings and menstrual cessation. In the clinical trial of women with bleeding cessation, 70 of those receiving the LD-OC pill experienced menstrual bleedings again, compared with only 22.7 in the placebo group. The discontinuation rate in the drug group was lower than in the placebo group as well (p<0.05). Conclusions: Treating the menstrual cessation caused by DMPA with LD-OC improves the bleeding pattern and decreases the discontinuation rate. © Med Sci Monit, 2006