Amenorrhea following oral contraception

Abstract

A prospective study was done on 326 nulliparous women who ceased oral contraception. Follow-up was obtained on 311. The mean age was 20.3 years (S.D. 2.5). Eighty-nine per cent began menstruating within 60 days after stopping therapy, and only 7 took 180 days or longer to menstruate. Late menarche strongly correlated with post-pill amenorrhea (PPA), but continous length of time on oral contraceptives and type of oral contraceptive showed no significant relationship. The incidence of PPA was 2.2 per cent. All women did eventually menstruate spontaneously, the longest period of amenorrhea being 540 days.

PIP: To delineate the parameters which may predispose to postpill amenorrhea (PPA) of 6 months or more duration, a 3-year prospective study of 326 16-38 year old (mean, 20.3 years) nulliparous women was done at Brown University. Follow-up was obtained on 311 cases. 98% of these patients had not been amenorrheic for longer than 60 days during t he year prior to using oral contraceptives. Previous irregular menses w as not a predisposing factor to PPA. 89% began menstruating within 60 days after stopping oral contraceptives and only 11 took 120-179 days to menstruate; 7 took 180 days or longer. All of the 311 patients eventual ly menstruated spontaneously. The longest period of amenorrhea was 540 days. The incidence of PPA was 2.2% (p less than .001). The number of months any patient was on the pill continuously before stopping therapy showed no correlation with the time of onset of first menses. Of the 7 patients with PPA, 3 had their menarche at age 16 years, none older. There were only a total of 12 patients with menarche as late as 16 years. The less the number of years between menarche and the beginning or oral contraceptives, the longer it took these patients to menstruate.