title: Low-dose oral contraceptive to re-induce menstrual bleeding in amenorrheic women on DMPA treatment: a randomized clinical trial.
abstract: BACKGROUND
  Depot medroxy progesterone acetate (DMPA) is one of the most reliable contraceptive methods with a failure rate less than 0.3 percent. It is injected every three months and Although it has many advantages over many other hormonal contraceptives, But a major disadvantage of it is bleeding disorders which comprise most of the discontinuance reasons. Our Aim was to study bleeding complications of DMPA when used as a contraceptive in Ardabil district and clinical trial of LD and Ethynil oestradiol in controlling these complications.
  
  
  METHODS
  All the 917 women who referred to ardabil's health centers for having 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 9 questionnaires 7 of them used for descriptive and 2 for clinical trial study. Data was analyzed by 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 menstrual cessation caused by DMPA with LDs, improves the complication and decreases the discontinuance rate.
authors.affiliation: Deputy for Research, Ardabil University of Medical Sciences, Raheh Daneshgah Ave, Ardabil, Iran. homayoun.sadeghi@arums.ac.ir
authors.forename: Homayou
authors.initials: H
authors.lastname: Sadeghi-Bazargani
authors.forename: Farnaz
authors.initials: F
authors.lastname: Ehdaeivand
authors.forename: Shahnam
authors.initials: S
authors.lastname: Arshi
authors.forename: Hasan
authors.initials: H
authors.lastname: Eftekhar
authors.forename: Hashem
authors.initials: H
authors.lastname: Sezavar
authors.forename: Louiz
authors.initials: L
authors.lastname: Amanati
mesh_terms: D000328:Adult; D000568:Amenorrhea / Q000139:chemically induced / Q000188:drug therapy*; D003276:Contraceptives, Oral / Q000008:administration & dosage* / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage* / Q000009:adverse effects*; D008598:Menstruation / Q000187:drug effects*; D010349:Patient Compliance; D016896:Treatment Outcome
chemical_list: D003276:Contraceptives, Oral; D017258:Medroxyprogesterone Acetate