The efficacy, acceptability and continuation of postpartum, post-abortive progestin-only pill: a pioneering prospective multicentric study from Turkey

Abstract

Objective: The aim of this study was to evaluate the efficacy, side-effects and continuation rate of the desogestrel-progestin-only-pill (POP) in postpartum and post-abortive Turkish women and its relation with breast-feeding. Material and Methods: In this prospective multicentric study women who delivered (or had surgical abortion) and wanted to receive POP for contraception were recruited to the study. The follow-up visits were scheduled at the third, sixth and ninth months. Results: Overall A total of 7,468 women (66.5% postpartum, 33.5% post-abortive) participated in the study. The number of women who attended follow-up visits in relation to the previous visit at the third, sixth and ninth months was 944/7,468 (12.6%), 406/944 (43%) and 121/406 (29.8%) respectively. The incidence of breastfeeding at all visits was between 54.8% and 68.4%. Out of the 7,468 women recruited only 6% continued with the method at the end of the ninth month. There was a statistically significant increase in hemoglobin level at the third month compared to initial values. Oligomenorrhea, spotting and headache were the three leading side-effects. There was no pregnancy among the patients who were followed up. Conclusion: This study demonstrated that POP was an effective postpartum and post-abortive contraceptive method that had no negative impact on breast-feeding. A change in bleeding patterns was the most common side-effect. However, the possible causes of low contraceptive maintenance rates need to be investigated.

Safety of Progestogen Hormonal Contraceptive Methods during Lactation: An Overview

“…Also, in a study by Dutta et al [ 28 ], no differences were found in the amount of milk produced, growth, and the development of infants between the DSG ( n = 200) and PLACEBO ( n = 200) groups for 6 months, starting at 6 weeks postpartum [ 28 ]. Dilbaz et al [ 29 ] also reported no negative effects of DSG on breastfeeding among 4964 women (DSG from day 21 postpartum). During follow-up, the percentage of women breastfeeding at 3, 6, and 9 months postpartum was 68.4%, 54.8%, and 58.5%, respectively [ 29 ].…”

“…Dilbaz et al [ 29 ] also reported no negative effects of DSG on breastfeeding among 4964 women (DSG from day 21 postpartum). During follow-up, the percentage of women breastfeeding at 3, 6, and 9 months postpartum was 68.4%, 54.8%, and 58.5%, respectively [ 29 ]. On the other hand, in a study by Janus et al [ 30 ], after 28 days of DSG use (3 months postpartum), contraception was discontinued due to the onset of scrotal hair in the newborn (resolved at 11 months) [ 30 ].…”

Hysteroscopic evaluation of endometrial changes and fallopian tubal functions in women using progestin-only contraceptives

“…1 However, the incidence of unwanted and distressing forms of abnormal uterine bleeding (AUB) was sign-ificantly higher with POCs than with other methods. [2][3][4][5][6][7] There is a need for a better understanding of the mechanisms of AUB in women using POCs, 8 and thus for individualized treatment rather than the current empirical lines of therapy. 9 Office hysteroscopy (OH) has long been used to examine the uterine cavity in many gynecological conditions such as AUB, 10 unexplained infertility, and recurrent pregnancy loss.…”