RHL Commentary by Biran Affandi
EVIDENCE SUMMARY
This review aimed to assess the contraceptive efficacy, bleeding patterns, discontinuation, user preferences, and side-effects of combination injectable contraceptives. The included trials had compared combination injectables with either progestogen-only methods or the intrauterine device (IUD).
The 25 mg depot-medroxyprogesterone acetate (DMPA) + 5 mg estradiol cypionate (E2C) and 50 mg norethisterone enantate (NET-EN) + 5 mg estradiol valerate (E2V) combinations had higher rates of cyclical (regular) bleeding, less amenorrhoea and fewer infrequent bleeding pattern than only150 mg DMPA and 200 mg NET-EN, respectively. Women using 150 mg DMPA were more likely to discontinue for amenorrhoea or bleeding problems. In contrast, women using 25 mg DMPA + 5 mg E2C were more likely discontinue early for 'other medical' reasons. Women using the 50 mg NET-EN + 5 mg E2V combination had higher rates of cyclical (regular) bleeding and lower rates of infrequent bleeding patterns compared with progestogen-only contraceptive, 200 mg NET-EN.
Life-table analysis found no difference in the overall discontinuation rates between the combination injectables 25 mg DMPA + 5 mg E2C and 50 mg NET-EN + 5 mg E2V.
The full RHL commentary also includes sections on: Relevance
- Magnitude of the problem
- Applicability of the results
- Implementation of the intervention
Research
References
This document should be cited as: Biran Affandi. Combination injectable contraceptives for contraception: RHL commentary (last revised: 20 February 2006). The WHO Reproductive Health Library, No 9, Update Software Ltd, Oxford, 2006. www.rhlibrary.com
|
