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VAGINAL BLEEDING DISTURBANCES ASSOCIATED bWITH THE DISCONTINUATION OF LONG‐ACTING INJECTABLE CONTRACEPTIVES
Author(s) -
Gray R. H.,
Parker R. A.,
Dlethelm P.
Publication year - 1981
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1981.tb00988.x
Subject(s) - medicine , discontinuation , medroxyprogesterone acetate , vaginal bleeding , pregnancy , amenorrhea , obstetrics , gynecology , breakthrough bleeding , family planning , randomized controlled trial , population , surgery , research methodology , hormone , environmental health , biology , genetics
Summary A randomized comparative trial of 832 women receiving norethisterone oenanthate (NET‐OEN) and 846 women receiving depot medroxyprogesterone acetate (DMPA) injections at 12 week intervals was conducted in 10 centres. The pregnancy rate with NET‐OEN was significantly higher than with DMPA. The termination rate for amenorrhoea was substantially lower with NET‐OEN than DMPA, whereas the discontinuation rates for bleeding problems were similar with the two drugs. Analysis of bleeding patterns among continuing and discontinuing users suggests that women tolerated frequent bleeding episodes, but found prolonged bleeding or prolonged bleeding‐free intervals unacceptable. Bleeding for more than 30 days during an injection interval and complete amenorrhoea for a whole injection interval were jointly associated with 43.7 per cent of all terminations among NET‐OEN users and 64.5 per cent of all terminations among DMPA users. In future efforts to improve the acceptability of long‐acting injectable contraceptives, more attention should be given to the control of prolonged amenorrhoea and prolonged bleeding.