Supplementary Files
Keywords
levonorgestrel
lynestrenol
bleeding patterns
breastfeeding
How to Cite
Abstract
Background: Progesterone-Only Pill (POPs) is one of the ideal oral contraceptive methods for breastfeeding women. Discontinuation of POPs was mostly due to bleeding pattern disorders.
Objective: The purpose of this study is to identify the prevalence and pattern of uterine bleeding on breastfeeding women using contraceptive pills containing progesterone derivatives.
Methods: This study is a double blind block randomized controlled trial for the treatment group (levonorgestrel or lynestrenol pills) and non-randomized controlled trial for the control group, 6-8 weeks' postpartum women, 20 to 35-year-old, and breastfeeding. Monthly follow up was done for 6 months. Analysis was done using survival analysis, X2,and Cox's Proportional Hazard.
Results: A hundred and seven women were involved with a drop-out rate of 17.8%. Subjects characteristics were ≤ 32-year-old, multiparous, ever used contraception with birth spacing of >60 months. Spotting and amenorrhea was the most common pattern. Levonorgestrel causes bleeding/menstrual resumption sooner in breastfeeding women than Lynestrenol.
Conclusion: The most common uterine bleeding on women using Progesterone-only Pills were spotting and amenorrhea. By recognizing such effects, for Indonesian women, POPs was expected to be produced in the country and can be included in the national family planning programs.
References
Bachmann, G., & Korner, P. (2007). Bleeding patterns associated with oral contraceptive use: a review of the literature. Contraception, 76(3), 182-189. doi:http://dx.doi.org/10.1016/j.contraception.2007.05.081
Belfield, T. (2009). Principles of contraceptive care: choice, acceptability and access. Best Practice & Research Clinical Obstetrics & Gynaecology, 23(2), 177-185. doi:http://dx.doi.org/10.1016/j.bpobgyn.2008.11.006
Busby, G. (2016). Menstrual dysfunction. Obstetrics, Gynaecology & Reproductive Medicine, 26(5), 149-154. doi:http://dx.doi.org/10.1016/j.ogrm.2016.02.003
d'Arcangues, C., Jackson, E., Brache, V., & Piaggio, G. (2011). Women's views and experiences of their vaginal bleeding patterns: an international perspective from Norplant users. Eur J Contracept Reprod Health Care, 16(1), 9-17. doi:10.3109/13625187.2010.535871
De Melo, N. R. (2010). Estrogen-free oral hormonal contraception: benefits of the progestin-only pill. Women's Health, 6(5), 721-735.
Dinh, A., Sriprasert, I., Williams, A. R., & Archer, D. F. (2015). A review of the endometrial histologic effects of progestins and progesterone receptor modulators in reproductive age women. Contraception, 91(5), 360-367. doi:http://dx.doi.org/10.1016/j.contraception.2015.01.008
Dwivedi, L. K., & Dixit, P. (2012). Relationship Between Breastfeeding and Postpartum Amenorrhea among Indian Women: An Epidemiological Appraisal. African Journal of Basic & Applied Sciences, 4(2), 30-37.
Edelman, A. B., Cherala, G., & Stanczyk, F. Z. (2010). Metabolism and pharmacokinetics of contraceptive steroids in obese women: a review. Contraception, 82(4), 314-323. doi:http://dx.doi.org/10.1016/j.contraception.2010.04.016
Espey, E., Ogburn, T., Leeman, L., Singh, R., & Schrader, R. (2012). Effect of progestin vs. combined oral contraceptive pills on lactation: A double-blind randomized controlled trial. Obstetrics and gynecology, 119(1), 5.
Freeman, S., & Shulman, L. P. (2010). Considerations for the use of progestin"only contraceptives. Journal of the American Academy of Nurse Practitioners, 22(2), 81-91.
Gustina, E., & Djannah, S. N. (2015). Sumber informasi dan pengetahuan tentang menstrual hygiene pada remaja putri. Jurnal Kesehatan Masyarakat, 10(2), 147-152.
Ichsan, B. S., Harsono; Soebijanto. (2015). Keefektifan Program Kelompok Pendukung Ibu dalam Mengubah Perilaku Ibu Menyusui Jurnal Kesehatan Masyarakat, KEMAS 10 (2) (2015) 186-194.
Kaneshiro, B., Edelman, A., Carlson, N. E., Nichols, M., & Jensen, J. (2012). Unscheduled bleeding with continuous oral contraceptive pills: a comparison of progestin dose. Contraception, 86(1), 22-27.
King, J. (2007). Contraception and lactation. Journal of Midwifery & Women's Health, 52(6), 614-620.
Phillips, S. J., Tepper, N. K., Kapp, N., Nanda, K., Temmerman, M., & Curtis, K. M. (2015). Progestogen-only contraceptive use among breastfeeding women: a systematic review. Contraception, 94(3), 226-252. doi:10.1016/j.contraception.2015.09.010
Shoupe, D., Ballagh, S., & Mishell Jr, D. (1992). Bleeding patterns in Norplant contraceptive implant users. Steroid Hormones and Uterine Bleeding. AAAS Press, Washington, DC, USA, 49-57.
Speroff, L., & Darney, P. D. (2010). A clinical guide for contraception: Lippincott Williams & Wilkins.
Susiloretni, K. A., Hadi, H., Prabandari, Y. S., Soenarto, Y. S., & Wilopo, S. A. (2015). What Works to Improve Duration of Exclusive Breastfeeding: Lessons from the Exclusive Breastfeeding Promotion Program in Rural Indonesia. Maternal and Child Health Journal, 19(7), 1515-1525. doi:10.1007/s10995-014-1656-z
Taraborrelli, S. (2015). Physiology, production and action of progesterone. Acta obstetricia et gynecologica Scandinavica, 94(S161), 8-16.
Zigler, R. E., & McNicholas, C. (2017). Unscheduled vaginal bleeding with progestin-only contraceptive use. Am J Obstet Gynecol, 216(5), 443-450. doi:10.1016/j.ajog.2016.12.008
Authors who publish with Public Health of Indonesia agree to the following terms:
- Authors retain copyright licensed under a Creative Commons Attribution-NonCommercial CC BY-NC 4.0, which allows others to remix, tweak, and build upon the authors' work non-commercially, and although the others' new works must also acknowledge the authors and be non-commercial, they don't have to license their derivative works on the same terms.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access). Authors can archive pre-print and post-print or publisher's version/PDF.