Usefulness of FSH measurements for determining menopause in long-term users of depot medroxyprogesterone acetate over 40 years of age

Carbohydrate complexity and proportion of serum FSH isoforms reflect pituitary–ovarian activity in perimenopausal women and depot medroxyprogesterone acetate users

“…A frequent question posed by DMPA users in this period of life is if they are effectively postmenopausal in order to cease contraceptive use. The clinical utility of immunoactive FSH levels to evaluate ovarian activity in DMPA users who are in amenorrhoea remains controversial, particularly, during the menopausal transition 19 . Under this condition, to determine the oligosaccharide characteristics of serum FSH, particularly when immunoactive FSH levels are high, may give additional information about the endocrine status of women using DMPA during menopausal transition.…”

Contraception in women over 40 years of age

“…These hormone levels are not suppressed substantially during DMPA use, but similarly they may be an unreliable signal of menopause in younger users. [75][76][77] Two studies showed that FSH levels were significantly suppressed in women who were using estrogen-containing oral contraceptives and may not rebound until 2 weeks after the last active pill; 77,78 therefore, FSH measurement during oral contraceptive use may not be reliable in determining menopausal status. In the absence of contraindications or risk factors, estrogencontaining and progestin-only hormonal contraception can be safely continued until age 55.…”

Menopause: A Global Perspective and Clinical Guide for Practice

“…In depot-medroxyprogesterone acetate users, FSH levels are not usually affected and women ages 50 to 55 years old can check FSH on the day of injection and repeated 13 weeks later before the next injection. If both levels are >30 IU/L depot-medroxyprogesterone acetate can be discontinued 11,18,22…”