Once a month administration of mifepristone improves bleeding patterns in women using subdermal contraceptive implants releasing levonorgestrel.
It has been suggested that the administration of an anti-progesterone might improve bleeding patterns in women with irregular bleeding while using low-dose progestin-only contraception. We report the findings of a double-blind, randomized, placebo-controlled trial of mifepristone 50 mg taken once every 4 weeks in 100 Chinese women (50 subjects and 50 controls) complaining of frequent and irregular bleeding while using a levonorgestrel-releasing subdermal contraceptive implant. In all women, regardless of treatment, the frequency of bleeding decreased significantly over 360 days of observation. Women recorded significantly shorter episodes of bleeding (P: < 0.0002) during mifepristone treatment than during the 90 days before treatment started. In contrast, the duration of bleeding episodes fell more gradually in placebo-treated controls. Women using mifepristone were more likely to find treatment acceptable than women receiving a placebo tablet (P: < 0.01). Despite concern that anti-progestogenic effects may jeopardize contraception, there were no pregnancies. This approach may offer a useful strategy to improve continuation rates by alleviating unwanted side-effects until bleeding patterns improve spontaneously with time.
Cheng
L
L
Shanghai Institute of Family Planning Technical Instruction, International Peace Maternity and Child Health Hospital, Jiaxing Reproduction Health Care Centre, Shanghai, People's Republic of China.
Zhu
H
H
Wang
A
A
Ren
F
F
Chen
J
J
Glasier
A
A
D000293:Adolescent; D000328:Adult; D003271:Contraceptive Agents, Female / Q000009:adverse effects*; D004311:Double-Blind Method; D004343:Drug Implants; D005260:Female; D006727:Hormone Antagonists / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D016912:Levonorgestrel / Q000009:adverse effects*; D015735:Mifepristone / Q000008:administration & dosage* / Q000627:therapeutic use; D010919:Placebos; D011374:Progesterone / Q000037:antagonists & inhibitors*; D013997:Time Factors; D014592:Uterine Hemorrhage / Q000139:chemically induced / Q000188:drug therapy*
D003271:Contraceptive Agents, Female; D004343:Drug Implants; D006727:Hormone Antagonists; D010919:Placebos; D015735:Mifepristone; D011374:Progesterone; D016912:Levonorgestrel