The use of quinesterol for the control of vaginal bleeding irregularities caused by DMPA

Abstract

A comparative clinical trial examined the effect of oral administration of a long-acting estrogen (quinesterol) on the vaginal bleeding pattern of 214 Thai women receiving 3 monthly injections of the contraceptive depot-medoxyprogesterone acetate. Although the proportion of subjects with amenorrhea was lower in the group receiving quinesterol, there was no substantial increase in the proportion of women with normal bleeding patterns.

PIP: In a double-blind clinical trial the effect on the bleeding pattern disrupted by progesterone-only injectable contraception of quinestrol, an estrogen which is stored in body fat and is slowly released over days, was studied in 236 Thai women giving informed consent and having irregular or nonexistent bleeding patterns since the start of Depo-Provera contraception. In all 214 women participated in the complete trial, receiving 3 monthly injections of depot-medroxyprogesterone acetate. The bleeding pattern showed no statistical significance between the quinestrol-treated group and placebo group in terms of the overall effects on the following definitions: acceptable bleeding, amenorrhea, irregular bleeding and prolonged bleeding. However, there was an apparent increase in amenorrhea in the placebo group after the second injection of progestin as well as a fall in irregular bleeding. Prolonged bleeding was seen most frequently after the first injection, and declined during the later injection study periods. Acceptable bleeding occurred in only 6 of 78 subjects in the fourth injection group. Hence, the use of quinestrol in this trial did not significantly change the bleeding pattern of depot-medroxyprogesterone acetate users.