Human Reproduction, Vol. 15, No. 9, 1969-1972,
September 2000
© 2000 European Society of Human Reproduction and Embryology
Once a month administration of mifepristone improves bleeding patterns in women using subdermal contraceptive implants releasing levonorgestrel
1 Shanghai Institute of Family Planning Technical Instruction, International Peace Maternity and Child Health Hospital, 2 Jiaxing Reproduction Health Care Centre, Shanghai, People's Republic of China and 3 University of Edinburgh, Department of Obstetrics and Gynaecology, Edinburgh, UK
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.
Key words: bleeding/contraception/implants/mifepristone/progestin-only
4 To whom correspondence should be addressed at: Department of Obstetrics and Gynaecology, University of Edinburgh Centre for Reproductive Biology, 37 Chalmers Street, Edinburgh EH3 9ET, UK. E-mail: a.glasier{at}ed.ac.uk
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