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Query: UMLS:C0745411 (irregular bleeding)
 386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The contraceptive efficacy and menstrual abnormalities of long-acting medroxyprogesterone acetate, injected intramuscularly at doses of 150 mg. every 3 months for 1 year, were studied in 14 women (mean age 33 years, mean parity 4.6). No pregnancies were reported and there were no significant changes in weight or blood pressure. All Papanicolaou smears, taken initially and at 6 and 12 months, were normal and there were no reports of emotional instability, nausea, vomiting, or breast soreness. Results of endometrial biopsies, taken at 6,9, and 12 months are given. The occurrence of spotting and bleeding was erratic (spotting for as long as 20-38 days in a 3-month period), but both tended to decrease as the treatment continued. After cessation of therapy, most patients had 2 or 3 "normal menstrual periods," which biopsy proved to be from a proliferative endometrium. All patients had a secretory endometrium within 12 months after the last injection, or within 9 months after the effects of the last injection had presumably worn off. Disadvantages to MA include fear of injection, irregular bleeding and spotting, and prolonged anovulation after therapy discontinuation. The chief advantage is the infrequent need for injection; patients need to be concerned with birth control only 1 day every 3 months.
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PMID:Contraceptive and endometrial effects of medroxyprogesterone acetate. 577 97

More than 300 subscribers of Contraceptive Technology Update (CTU) completed the questionnaire for the 1994 Pill Survey. Most respondents (68%) were nurse practitioners followed by physicians (11%), registered nurses (9%), and physician assistants (4%). 92% of respondents considered oral contraceptives (OCs) (especially Ortho-Cept and Ortho Novum 7/7/7) as the leading hormonal contraceptive choice among adolescents and adults. Among teens, Depo-Provera was the second choice (4%). Among adults, Depo-Provera and the contraceptive implant, Norplant, fared equally as well (2% each). Headaches, mood swings, and weight gain continued to be complaints for all hormonal contraceptives. Progestins are potent depressants. Norplant produced the most complaints. About 20% of providers reported that at least 20% of their patients wanted Norplant implants removed because of significant side effects, especially irregular bleeding. Most Norplant users had the implants for no more than 12 months. The providers realized that they were providing insufficient counseling to Norplant users about irregular bleeding before insertion. A physician noted that some women experience infertility for as long as two to three years after their last Depo-Provera injection. Some providers discourage women from using Norplant based on the many complaints they have received from past users.
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PMID:Depo-Provera and Norplant implants prove no competition for no. 1 choice, OCs. The 1994 pill survey. 1228 3

Family planners responding to an annual oral contraceptives (OC) survey tended to recommend switching pills for complaints of headaches and mood swings and life style changes for the complaint of weight gain. Nearly 3/4 of survey respondents indicated that headaches and mood swings affected less than 5% of their patients. On the other hand, 29% reported that less than 5% of patients complained of weight gain; 27% said 10% complained; 19% said 10-15% complained; 10% said 15 to 20% complained; and 14% said more than 20% of patients complained of weight gain. 57% of the 137 respondents would instruct patients to exercise more and reduce calorie intake, and only 13% would change a patient's pill formulation because of weight gain. Nausea, breast changes, breakthrough bleeding, and compliance issues seem to be more relevant to birth control pills. However, a study indicated that women who discontinue more often do it because more often do it because of weight gain or acne than because of irregular bleeding or amenorrhea. Some women have gained 10-30 lbs using OCs. Researchers in Sweden recorded the secretion of the satiety hormone cholecystokinin during a 24-hour period before and during administration of OCs to 9 women, and found that pills suppressed the serum profiles of cholecystokinin inducing the feeling of hunger. Further studies are needed to evaluate the mechanism of this effect.
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PMID:Lifestyle changes most often suggested for weight complaints. Special report: annual pill survey. 1234 23