Original Articles

Comparison of Continuation Rates and Reasons of Discontinuation for Cyclofem and Depot -medroxyprogesterone acetate in Rural Areas of East Azerbaijan Province, Iran

Abstract

Objective: In this study continuation rate and reasons for discontinuation of Depot-medroxyprogestrone
acetate (DMPA)and Cyclofem have been compared.
Materials and methods: A retrospective cohort study was conducted with 422 women (202 Cyclofemand 220 DMPA users)who had started using the methods 12-24 months before the study in East Azerbaijan health houses. Data were collected by reviewing the records and interview with the clients and analysed using Kaplan-Meier and Cox Regression.
Results: The 3, 6, 9, 12 months continuation rate were 56%, 37%, 30%, 27% respectively for Cyclofem versus 75%, 59.5%, 48%, 42.5% for DMPA. Menstrual changes were reported significantly more by the DMPA users than the Cyclofem users (85% vs. 73%, P=0.008) as the main reason for the discontinuation, the difference mainly reflected of amenorrhea (50% vs. 23%, P=0.003). None of DMPA users and 11% of Cyclofem users claimed frequency of visits and lack of method supplies as their main discontinuation reason.
Conclusion: Discontinuation rate was high for the both methods but it was higher for Cyclofem.The common side effects mentioned as the main reasons for discontinuation of the both methods are not health threatening. Therefore, health care providers may help to improve their continuation rate by appropriate consultation.

Aradhyakw. Focus on improving hormonal method continuation. Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, INFO Reports. No 9. Baltimore, INFO Project. March 2007.

Statistics and Medical Information Office. Family planning and contraceptives index. http://ict1.tbzmed.ac.ir/national%20surveys/demograph ic%20and%20health%20survey/index5-2.htm . (Persian)

Rominjo joseph K, Sekkadde C, Karanja J, Rivera R, Nasutiou M, Nutley T. Comparative acceptability of combined and progestine only injectable contraceptives in Kenya. Contraception 2005;72: 138-45.

Gallo MF, Grimes DA, Lopez LM, Schulz KF, d'Arcangues C. Combination injectable contraceptives for contraception. Cochrane Database Syst Rev 2008; 4:CD004568.

Cuaong DT, MyHuong NT. Contraceptive phase III clinical trial of two injectable contraceptive preparations, Depot-medroxyprogesterone acetate and Cyclofem, in Vietnamese women. Contraception 1996; 54:169–79.

Moreau C, Cleland K,Trussell J. Contraception discontinuation attributed to methods dissatisfaction in the united states. Contraception 2007; 76; 267-72.

HomaionfarN,SEHATI F,MARDI A,AMANI F,JAFARZADEH H.[Continuation of injectable form of DMPA usage in Ardabil Health Centers 2005]. Journal of Ardabil university of medical sciences 2007; 7:418-22. (Persian)

Ranji A. [Knowledge, attitude and practice of Depotmedroxyprogesterone acetate users from it in Tabriz]. MSc thesis, Nursing and Midwifery faculty, Tabriz University of Medical Sciences, Iran. 2000.

Hassan EO, El-Nahal N, El-Hussein M. Acceptability of the once-a-month injectable contraceptives Cyclofem and Mesigyna in Egypt. Contraception1994; 49:469–88.

Sang GW, Shao QX, Ge RS, Ge JL, Chen Jk, Sang S, et al. A multicentred phase III comparative clinical trial of mesigyna, cyclofem and injectable no. 1 given monthly by intramuscular injection to Chinese women: I. Contraceptive efficacy and side effects. Contraception 1995; 51:167–83.

Hall P, Bahamondes L, Diaz J, Petta C. Introductory study of the once a-month, injectable contraceptive Cyclofem in Brazil, Chile, Colombia, and Peru. Contraception 1997; 56:353–9.

Garza-Flores J, Moraks del Olmo A, Fuziwara JL, Figueroa JG, Alonso A, Monroy J, et al. Introduction of cyclofem once-a-month injectable contraceptive in Mexico. Contraception 1998; 58:7-12.

Kaunitz AM, Garceau RJ, Cromie MA and the Lunelle Study Group. Comparative safety, efficacy, and cycle control of Lunelle monthly contraceptive injection (medroxyprogesterone acetate and estradiolcypionate injectable suspension) and Ortho-Novum 7/7/7 oral contraceptive (norethindrone/ethinylestradioltriphasic). Contraception 1999; 60:179–87.

Mahdy NH, el-Zeiny NA. Probability of contraceptive continuation and its determinants. Eastern Mediterranean health journal 1999; 5:526–38.

Lei ZW, Chun Wu S, Garceau RJ, Jiang S, Yang QZ,Wang WL, et al. Effect of pretreatmentcounseling on discontinuation rates in Chinese women givenmedroxyprogesterone acetate for contraception.Contraception 1996; 53:357–61.

Canto De Cetona, Canto P, Luna Mo. Effect of counseling to improve compliance in Mexican women receiving depot-medroxyprogestrone acetate.Contraception 2001; 63:143-6.

Mohammad-Alizadeh S, Marions L, Vahidi R, Nikniaz A, Johansson A, Wahlstrom R. Quality of reproductive health services at primary health centers in an urban area of Iran Emphasis on family planning. The European Journal of contraception and Reproductive health care 2007; 12 :326-34.

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SectionOriginal Articles
Keywords
Cyclofem DMPA Continuation rate Discontinuation reason

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How to Cite
1.
Hassanzadeh R, Kamalifard M, Bazargani H, Charandabi S. Comparison of Continuation Rates and Reasons of Discontinuation for Cyclofem and Depot -medroxyprogesterone acetate in Rural Areas of East Azerbaijan Province, Iran. J Family Reprod Health. 2012;6(1):23-27.