Study of menstrual pattern changes in patients accepting injection depo-medroxyprogesterone acetate versus levonorgestrel intrauterine system
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20210295Keywords:
DMPA, LNG-IUS, Menstrual changesAbstract
Background: Changes in menstrual bleeding patterns are a major cause of hormonal contraceptive discontinuation. DMPA and LNG IUS both are hormonal contraceptives and are used by most of the women worldwide for various gynaecological conditions. The aim of the present study was to compare menstrual pattern changes in patients accepting injection DMPA and LNG-IUS for various gynaecological indications.
Methods: This randomized controlled trial was conducted among 70 women aged 18 years or older with heavy menstrual bleeding in the department of Obstetrics and Gynaecology, Chhatrapati Shivaji Subharti Medical College, Meerut. The study comprised of two groups having 35 patients each i.e. Group 1 (patient who opted for LNG IUS) and Group 2 (patient who opted injection DMPA). The menstrual pattern changes were assessed at 1month, 3month and 6th month interval. Patient were asked to maintain a menstrual calendar wherein she would keep a record of the no. of days along with dates when she has spotting per vaginum/bleeding per vaginum and the amount of blood loss explained to her through the pictorial blood assessment chart.
Results: Reduction in median menstrual blood loss was significantly greater in the LNG IUS group (-128.12mL, range -393.6 to 328.5 mL) than in the DMPA group arm -17.8 mL, range -271.5 to+78.6 mL, p<0.001).
Conclusions: LNG IUS reduces menstrual blood loss more effectively than DMPA.
Metrics
References
Kjerulff KH, Erickson BA, Langenberg PW. Chronic gynecological conditions reported by US women: Findings from the national health interview survey, 1984 to 1992. Am J Public Health. 1996; 86:195-9.
Barnard K, Frayne SM, Skinner KM, Sullivan LM. Health status among women with menstrual symptoms. J Women’s Health. 2003;12:911-9.
Wu JM, Wechter ME, Geller EJ, Nguyen TV, Visco AG. Hysterectomy rates in the United States, 2003. Obstet Gynecol. 2007;110:1091-5.
Whiteman MK, Hillis SD, Jamieson DJ, Morrow B, Podgornik MN, Brett KM, et al. Inpatient hysterectomy surveillance in the United States, 2000-2004. Am J Obstet Gynecol. 2008;198:34:e1-7.
National Collaborating Centre for Women’s and Children’s Health. Heavy menstrual bleeding Commissioned by the National Institute for Health and Clinical Excellence. 2007. Available at http://www.nice.org.uk/nicemedia/pdf/CG44Full Guideline.pdf. Accessed on 28 April, 2020.
Crosignani PG, Luciano A, Ray A, Bregqvist A. Subcutaneous depot medroxyprogesterone acetate Vs leuprolide acetate in the treatment of endometriosis-associated pain. Hum Reprod. 2006;21:248-56.
Schlaff WD, Carson SA, Luciano A, Ross D, Bergqvist A. Subcutaneous injection of depot medroxyprogesterone acetate compared with leuprolide acetate in the treatment of endometriosis-associated pain. Fertil Steril. 2006;85(2):314-25.
Arias RD, Jain JK, Brucker C, Ross D, Ray A. Changes in bleeding patterns with depot medroxyprogesterone acetate subcutaneous injection 104mg. Contraception. 2006;74(3):234-8.
Kaunitz AM, Bissonnette F, Monteiro I, Lukkari-Lax E, Muysers C, Jensen JT. Levonorgestrel-releasing intrauterine system or medroxyprogesterone for heavy menstrual bleeding: a randomized controlled trial. Obst Gynecol. 2010;116(3):625-32.
Danielsson GK, Schellschmidt I, Apter D. A randomized, phase II study describing the efficacy, bleeding profile, and safety of two low-dose levonorgestrel-releasing intrauterine contraceptive systems and Mirena. Fertil Steril. 2012;97(3):616-22.
Hu E, Ikeako LC, Okafor NC. The use of DMPA injectable contraceptive in Enugu Nigeria. Niger J Med. 2012;21(S):266-71.
Uysal A, Taner CE, Mun S, Uysal F, Celimli FH. Use of a levonorgestrel-releasing intrauterine device in the treatment of adenomyosis associated heavy menstrual bleeding. J Pak Med Assoc. 2013;63(11):1349-52.
Taru G, Nupur G, Sangeeta G, Pushpa B, Jyoti J, Sushma K. Levonorgestrel intrauterine system (LNG IUS) in menorrahgia: a follow-up study. Open J Obst Gynecol. 2014;2014.
Polis RL, Hertweck SP. Treatment options for the adolescent patient experiencing abnormal uterine bleeding. current treatment options in pediatrics. 2016;2(3):184-95.
Mejia M, McNicholas C, Madden T, Peipert JF. Association of baseline bleeding pattern on amenorrhea with levonorgestrel intrauterine system use. Contraception. 2016;94(5):556-60.
Oroma B, Nwanodi. Progestin intrauterine device versus intramuscular medroxyprogesterone acetate for heavy menstrual bleeding control. Open access J Gynecol Obstet. 2017, 1(1):002.
Downloads
Published
How to Cite
Issue
Section
