Medroxyprogesterone Research Articles

Availability and Access to Medications for Puberty Induction and Maintenance in Adolescents with Hypogonadism in the Arab Region.

Background Inducing puberty in hypogonadal patients enables achieving normal final adult height and healthy bone mass accrual and improves fertility potential. Reliable availability and access to medicines remain a challenge around the world, particularly in low-income countries. Aim We aimed to describe the availability/access to medications used for inducing and maintaining puberty in centers within the Arab region. Method A cross-sectional survey was conducted using a link to an online questionnaire, which was emailed to paediatric endocrinologists in the Arab region. The questionnaire consisted of three questions related to the availability of various forms of sex hormones. Results 99 physicians from 16 countries participated in the study. The commonest available form of estrogen was conjugated estrogen (29% of centers), followed by ethinylestradiol (26%). Depot estradiol was available in 11 centers, while topical estrogen preparations of gel and patches were available in 6 and 10 centers, respectively. Medroxy progesterone was available in 26% of the centers, followed by norethisterone (24%). The combined forms of oral and transdermal patches of estrogen/progesterone were available in 35% and 9% of centers, respectively. Intramuscular testosterone (Sustanon) was the most commonly available preparation of testosterone, followed by the depot injection (Nebido), oral testosterone, and testosterone gel and cream. Conclusions We report the first available data on medications used for puberty induction and maintenance in paediatric hypogonadism in the Arab region. Recommended preparations for this purpose are not widely available. Creating an essential list of medications used in paediatric endocrinology disorders might improve availability, access, and consequently practice.

Change of contraceptive preference after the free-LARC program for Thai teenagers

BackgroundIn 2014, the Thai government launched a free-of-charge long-acting reversible contraception (LARC) program for Thai female adolescents. However, its acceptance had not been reported. Therefore, this study aimed to describe contraceptive use among women of reproductive age before and after the program was implemented.MethodsThis retrospective cross-sectional study was carried out from the medical records of 9000 women of reproductive age, who attended the Family Planning Clinic at Maharaj Nakorn Chiang Mai Hospital between 2009 and 2018. The Chi-square test was used to compare the contraceptive methods administered before and after the program was implemented, and binary logistic regression was used to find the factors associated with implant use after completion of the program.ResultsDepot medroxy progesterone acetate (DMPA) injection was the most popular contraceptive method used among 40.9% of the women. The rates of subdermal implant use were increased significantly after the program was implemented (2.3–9.3%, p < 0.001). Implant use for adolescents aged less than 20 years increased from 2.6% to 56.4%, while DMPA was the most popular method used among adult women at 36.4%. Factors associated significantly with implant use after implement of the program included age of less than 20 years (aOR = 4.17 (CI: 1.84–9.44); p = 0.001) and nulliparity (aOR = 8.55 (CI: 3.77–19.39); p < 0.001).ConclusionThis study showed a significant increase in contraceptive implant use after the free-LARC program for adolescents had been applied.Statement of implicationsContraceptive implant is the most effective hormonal reversible contraception. Its use rate is low among all age groups, but increased clearly after the free-of-charge program was applied for adolescents.

“Effects of Medroxy Progesterone Acetate (Inject-Able Contraceptive) on Diameter of Graffian Follicle (Ovary) of Adult Albino Rats”

Objective: An injectable birth control called Medroxy Progesterone Acetate (MPA) was used in the study to see how it affects adult female albino rats' ovaries. Study design An experimental study Place of study : To conduct the research, scientists worked with animals at the Dow University of Health Sciences' Animal House, the Institute of Basic Medical Sciences, and the Dow Diagnostic Research and Reference Laboratory (DDRRL). In the months of April and July of 2012, researchers conducted their investigation. Materials and Method:For the purpose of the research, a total of 72 female albino rats were chosen and divided into three distinct categories. Each group was further subdivided into three smaller groups based on the length of time that the therapy session lasted. The experiment utilized a group size of n = 24, which served as the control. The dose of MPA that was given to Group B (which consisted of 24 people) was 3 mg/kg of body weight. Participants in Group C (n = 24) were given an MPA dose that was two times higher than those in Group A (3 mg/kg). A single injection of MPA was given to group B as well as group C at the beginning of the experiment. During the course of the research, it was noticed that the ovaries of the animals had changed both in terms of their shape and their structure. Hematoxylin, eosin, and masson's trichrome were the stains that were used to color the tissues of the ovary. With the assistance of an ocular and stage micrometer, even minute differences could be detected and measured. The Kruskal-Wallis test and Tukey's test are two examples of nonparametric statistical analysis that were used to investigate the differences in each group's variables. Result: In comparison to control groups, experimental animals fed MPA had significantly smaller diameters of graafian follicles (DOF) than animals in the control groups. There was a significant difference in depth-of-field (DOF) between groups A1, B1, and C1 after one month of treatment. Groups A2, B2, and C2 each had a DOF of 571.25 98.26 meters, 288.25 100.80 meters, and 179.0 37.23 meters. In groups A3, B3, and C3, the DOF ranged from 699.75 m to 128.7 m, 230.37 m to 20.83 m, and 159.37 m to 47.65 m. Conclusion: Research shows that MPA can lower the amount of follicular atresia as well as chronic anovulation, according to the findings of this study. With this study's findings, we can better understand the risks that hormonal contraceptives like injections have to women's health. Keywords: MPA: Medroxy progesterone acetate FSH:Follicular Stimulating Hormone ,LH: Luteinizing Hormone. DOF : Diameter of graafian follicles

Significance of Seminal Fructose Level in Spermatogenic Activity After Progesterone Treatment

Fructose is the main source of energy for the sperm motility. The degree of fructose utilization is directly proportional to the sperm motility. It could be the cause of negative correlation between sperm motility and semen fructose level. Fructose is a source of energy for the sperm motility. A parallel set of squirrels (Funambulus pennanti) treated with high and low doses of depot medroxy progesterone acetate (Depo provera), a synthetic progesterone for short and long term duration indicated that the spermatogenic activity in the seminiferous tubules was inversely related with the concentrations of seminal fructose. Thus the seminiferous tubules showing total arrest of spermatogenesis and atrophy of Leydig cells- anazoospermic condition, a significant increase in fructose values were observed, slight increase in the fructose values were registered in the oligozoospermic condition whereas a significant decrease in the fructose values were recorded in the partial arrest of spermatogenic activity. The results were supported by the cauda epididymal sperm count, histological changes in the Leydig cells histopathological changes in seminiferous tubules.

The Effect of Moringa Oleifera Leaf Water Extract on the Number of Ovarian Follicles and the Enzyme Levels of Superoxide Dismutase of Rattus Norvegicus Rats Exposed to Depot Medroxyprogesterone Acetate (DMPA)

Depot Medroxyprogesterone Acetate (DMPA) contraceptives result in reduced release of FSH and LH inhibiting ovarian follicular development and preventing ovulation. Prolonged hypoestrogen causes oxidative stress due to increased ROS. SOD enzymes prevent the formation of ROS. Moringa is a plant that contains high antioxidants and minerals which are cofactors for enzymes that protect against the effects of free radicals by neutralizing them before they damage cells and cause disease. The aims of this study were to determine the effect of Moringa oleifera leaf water extract on the number of ovarian follicles and levels of the enzyme superoxide dismutase in Rattus norvegicus rats exposed to Depo Medroxy Progesterone Acetate. The study was carried out at the Bukittingi Veterinary Laboratory and the Biomedical Laboratory, Faculty of Medicine, Andalas University, Padang. The study began in April - May 2021. The type of study was experimental with a Post Test Only Control Group Design with the number of sample of 30 female rats. The data were analyzed using the Shapiro Wilks normality test. After the parametric test is fulfilled, the hypothesis test is continued using one way ANOVA. The results of the analysis showed that there was a significant difference between the group k- mean (3.40) K+ mean (1.00) in primary follicles and mean k-(3.80) and K+(1.20). In secondary follicles and mean k- (4.20) the mean k+(1.40) in tertiary follicles and mean k-(2.60) mean k+(1.00) in Degraaf follicles. The significance value for all types of follicles with ANOVA test with p value &lt;0.05. The dose of 300 grams / kg / body weight per day is the dose that is most able to increase the number of ovarian follicles and SOD enzyme levels in the ovaries with a comparison rate close to the negative control group treatment value. The conclusion of the study was that administration of Moringa leaf water extract could increase the number of ovarian follicles and levels of the ovarian SOD enzyme in rats exposed to DMPA. Keywords: DMPA, Ovarian Follicle, SOD, Moringa leaf water extract.

Lama Penggunaan Kontrasepsi Depo Medroksi Progesteron Asetat dengan Indeks Massa Tubuh dan Kadar Kolesterol Total

BMI and total blood cholesterol levels in Depo Medroxy Progesteron Asetate family planning users in the work area of Puskesmas IV Denpasar Selatan in 2021. This study used a non-probability sampling technique with purposive sampling as many as 32 respondents. Collecting instruments through interviews and measuring Basal Metabolisme Indekx by measuring height and weight and measuring cholesterol levels using the EasyTouch GCU Kit. The results showed that most of the users of injection contraceptive Depo Medroxy Progesteron Asetate were 22 people 68.8% ≥24 months, most of the users of Depo Medroxy Progesteron Asetate injection contraception had a heavy Basal Metabolisme Indekx 40.6% and cholesterol normal levels 68.8%, rather high cholesterol 25.0% and high cholesterol 6.3%. Hypothesis testing used is the contingency coefficient with a Basal Metabolisme Indekx value of p = 0.001 (p&lt;0.05) and a cholesterol value of p = 0.037 (p&lt;0.05), so there is a relationship between the length of time using Depo Medroxy Progesteron Asetate injection contraceptives and Basal Metabolisme Indekx. and total cholesterol levels in the blood in Depo Medroxy Progesteron Asetate family planning acceptors users in the work area of Puskesmas IV South Denpasar in 2021. Based on the results of the study, it is hoped that this can be taken into consideration in providing education and counseling on how to overcome the side effects that occur, so that family planning acceptors Depo Medroxy Progesteron Asetate contraceptives are the only hormonal contraceptives that consistently have an effect on weight gain which results in changes in BMI and affects the lipid profile resulting in increased cholesterol levels. The purpose of this study was to determine the relationship between the duration of use of DMPA injection contraceptives with can overcome the problem of increasing. weight arising from the use of Depo Medroxy Progesteron Asetate family planning and the importance of measuring cholesterol levels regularly in Depo Medroxy Progesteron Asetate family planning acceptors.

The Correlation of Use of Depo Medroxy Progesterone Acetate (DMPA) In-jections with Lipid Profile Levels in Rats

Introduction: Family Planning is a national strategy of Indonesia government to manage the population growth. Depo Medroxyprogesterone Acetate (DMPA) is one of injectable contraceptives most widely used because it is simple and easy to obtain. However, it has various side effects causing imbalance of hormone estrogen, in turns to result in a decrease in HDL (High Density Lipoprotein) and an increase in LDL (Low Density Lipoprotein) which will result in an increase in total cholesterol. It will also affect changes in fat metabolism in human body due to hormonal influences. This results in dyslipidemia and atherosclerosis. Method: The method in this study is an experimental study with a pretest-posttest control group design. Results: The purpose of this study was to determine the relationship between duration of use of DMPA injections with lipid profile levels in mice. The data were analyzed by using the Paired t-test parametric test to compare between treatment groups. This study found that there were significant differences in HDL levels and total cholesterol levels between before and after administration of DMPA injections on the 14th and 35th days. There is a significant relationship between the duration of administration of DMPA injections with HDL levels and total cholesterol levels in mice. However, there was no difference in LDL levels and triglyceride levels between before and after administration of DMPA injection on day of 14 and day of 35, while, there was a significant difference between before and after the 35th day. There is no relationship between duration of administration of DMPA injections with LDL levels, while there is a relationship among mice triglycerides. Conclusions: Administration of DMPA injections for a long time lowers HDL.

Effect of Nonionizing Radiation on Progesterone Treatment in Endometrial Hyperplasia: An Experimental Rat Study

Objectives: The aim of the study was to evaluate the negative effect of nonionizing radiation on the treatment of endometrial hyperplasia (EH) with oral progesterone. Design: Forty oophorectomized Wistar Albino female rats were included in this experimental rat study. Materials and Methods: The 4 groups were planned as follows: Group A; sham group; Group B; group receiving oral estradiol hemihydrate 4 mg/kg/day; Group C; 4 mg/kg/day oral estradiol hemihydrate followed with 1 mg/day medroxy progesterone acetate (MPA) and Group D; 4 mg/kg/day oral estradiol hemihydrate followed with 1 mg/day MPA with exposure to nonionizing radiation at 1800 mHz/3 h/day. After the experimental model, uterine horns were sampled and the preparations were evaluated for pathological parameters (glandular density, epithelial cell length, and luminal epithelial cell length) via light microscopy. Nonionizing radiation was created by a signal generator and a compatible mobile phone. Results: Estrogen was found to increase all parameters related to EH (p < 0.05). Progesterone treatment was found to decrease parameters related to EH (Group B vs. C; luminal epithelial cell length, glandular density, and epithelial length; 11.2 vs. 13.2 μm p = 0.007; 32.5 vs. 35.5, p = 0.068; and 219.9 μm vs. 285 µm, p < 0.001, respectively). Final analyses revealed reduced effectiveness of progesterone treatment in the rats exposed to nonionizing radiation (Group C vs. D); luminal epithelial cell length, glandular density, and epithelial length (11.2 μm vs. 13.5 μm, p = 0.179; 32.5 vs. 52, p < 0.001; and 219.9 μm vs. 374.1 μm, p = 0.001, respectively). Limitations: The limitations of our study are that the results of animal experiments may not be appropriate for direct adaptation to humans and the relatively low number of rats included in the study. Conclusion: Nonionizing radiation reduces the effect of progesterone in patients receiving treatment for EH.

Durasi Kembalinya Kesuburan Paska KB Cyclofem dan Depo Medroksiprogesteron Asetat

Cyclofem and Depo Medroxy Progesterone Acetate (DMPA) are the most common types of contraception and are widely used, although there are still drawbacks such as disturbing menstrual patterns, weight gain, and delayed return of fertility. This study aims to determine the difference in the return of fertility between post-Cyclofem and DMPA acceptors in Gorontalo. 40 pregnant women were used in this study with the sampling technique used is purposive sampling. The study was conducted from May 25 to June 8, 2018. The data obtained were then analyzed using the independent t-test. The results showed that the return of fertility after Cyclofem was 7.1 months, and DMPA was 12.9 months. The value of t-count = 3.058 and sig. 0.004. There is a difference in the length of return of fertility between post-Cyclofem and DMPA family planning acceptors in Gorontalo. A larger research sample is needed so that the results obtained are better.

HUBUNGAN ANTARA KONTRASEPSI DMPA (DEPO MEDROXY PROGESTERON ASETAT) DENGAN PENINGKATAN BERAT BADAN AKSEPTOR KB DI PUSKESMAS PUNGGUR TAHUN 2018

The number of population in Indonesia is increasing, this is a big problem. Indonesia is the fifth country in the world with the highest estimated population of 249 million, with 2.6 Fertility or Total Fertility Rate (TFR) still high compared to other ASEAN countries with an average rate of 2.4 (Ministry of Health RI, 2014). Efforts to deal with the rate of Indonesian population hold a Family Planning program to achieve quality families, namely by regulating the number of children, while the most widely used contraceptives are DMPA injections, the most frequent side effect of DMPA injection contraception is weight gain which can result in drop out acceptors. The purpose of this study was to determine the relationship between DMPA (Depo Medroxy Progesteron Asetat) contraception and weight gain in KB acceptors at Punggur Health Center in 2018. The results of the research conducted by researchers on 133 respondents that there were 77 family planning acceptors (57.8%) using DMPA KB injections, and 73 acceptors (45.1%) KB acceptors at Purbolinggo Health Center experienced a one-year increase in weight after using the tool contraception. Based on the bivariate test of acceptors with DMPA injection contraception and weight gain of 43 (55.8%) KB acceptors. Based on the results of the chi-square analysis with a 95% confidence level obtained p-value = 0.004 &lt;α (0.05), then Ha is accepted and Ho is rejected or means there is a relationship between DMPA injections with an increase in birth control weight gain in Punggur Health Center in 2018 and the Odds Ratio (OR) is 2.9. It is expected that health workers to improve family planning services, especially in the case of DMPA contraceptive use. And it is expected that KB acceptors will increase their knowledge, especially regarding contraceptives to be chosen so that they can minimize the effects of contraceptive device use and play a role in the national family planning program, namely Active KB acceptors.

ANALISIS LAMA PEMAKAIAN KONTRASEPSI DEPO MEDROKSI PROGESTERON ASESTAT DENGAN GANGGUAN MENSTRUASI

Depo Medroxy Progesterone Acetate (DMPA) is a contraceptive in the form of injections given every three months containing the hormone progestin. This contraceptive is given by injection in the buttocks/arm area. The purpose of this study was to determine the analysis of the duration of the use of Depo Medroxy Progesterone Acetate injectable contraception with and menstrual disorders in the Bungo area in 2020. The research design used was a descriptive analytical method with a cross sectional approach. The population includes all mothers who use DMPA injection family planning with a sample of 77 respondents. The sampling technique was simple random sampling. The data used are secondary data and primary data obtained from data obtained from the Bungo City area. Data analysis using square test. The results showed that the use of DMPA injectable contraception was under 1 year and 84.6% used DMPA injectable contraception for more than 1 year and 6.5% under 1 year and 88.3% for more than 1 year using DMPA injectable contraception experienced menstrual disorders. Based on the results of the study, it was concluded that there was an effect of the duration of the use of DMPA injection family planning with menstrual disorders. So it is recommended to be able to often provide counseling about family planning counseling, especially DMPA injections because it is in great demand by family planning acceptors

Study of Efficacy and Safety of Injection Depot Medroxy Progesterone Acetate In Lactating and Non-lactating Women

Subject: This was a prospective study of efficacy and safety of injection depot medroxy progesterone acetate (DMPA) in lactating and non-lactating women. Abstract: The population of India is growing rapidly. The socio-economic problem of overpopulation is too well known. The use of safe and effective contraception is the need of the hour in India. Contraceptive advice is a vital component of good community health. Aims and Objective: The present study aims to study the establish safety and effectiveness of injection DMPA as a contraceptive method, acceptance, and continuation rate of injection DMPA in lactating mothers who had received first dose at postpartum period and non-lactating women and study the side effect of injection DMPA. Methods: A prospective study was conducted, at J K Lone mother and Child Hospital, Government Medical College Kota, Rajasthan, between April 2019 and April 2020. One hundred women were given injection DMPA 150 mg intramuscularly taken as study group and 100 women not using hormonal contraception were taken as controls group. They were followed at every 3 months. The comparison between the two groups was done using student t-test Chi-square test for calculation of p value. Results: The study was conducted to evaluate that women who were used DMPA mean age were 25.35 years. Overall accepted rate is 20%. No effect of literacy on acceptance rate. Significant menstrual irregularity found which was most common reason for attrition. Failure rate was zero among DMPA user. No significant effect on BP, blood sugar, and weight gain. No adverse effect on lactation. Conclusion: The study concludes that DMPA is a very effective contraceptive. Women accept it very easily without much degree of motivation. However, side effect decreases compliance.

FAKTOR – FAKTOR YANG BERHUBUNGAN DENGAN PENGGUNAAN KONTRASEPSI SUNTIK DEPO MEDROXY PROGESTERONE ACETATE (DMPA) DI PUSKESMAS MERAL KABUPATEN KARIMUN

Indonesia is a country recognized as the fourth biggest population in the world with 258,316,051 inhabitants. For the attempt to control the birth rate of the baby, Indonesian government implements a Family Planning program using various methods of contraception such as Depo Medroxy Progesterone Acetate (DMPA) injectable contraception that is often used by childbearing age couple. This study aims to determine promising factors associated with the use Depo Medroxy Progesterone Acetate (DMPA) contraception method particularly at Meral Health Centre of Karimun in 2018, namely factors of woman’s age and knowledge, as well as husband’s support. This research is an analytical survey with a cross sectional approach conducted from May to July 2018 with 99 respondents selected through simple random sampling technique. The research instrument used was questionnaires, then further analyzed by chi square statistical test. The result reveals a correlation between factor of wife’s age with the use of DMPA contraception with the p value = 0.007 <0.05, besides it is also noted a correlation between wife’s knowledge with the use of DMPA contraception with p value = 0.017 <0.05, and a correlation between husband’s support with the use of DMPA injectable contraception with p value = 0.023 <0.05. From the findings, it can be concluded that there is a significant correlation between woman’s age and knowledge also support of husband with the use of DMPA injectable contraception at Meral Health Center of Kamrimun in 2018. Finally, it is hoped that midwives as the medical personnel to develop both family planning information and services in form of counseling and assistance about contraceptive methods to be use by the participants.

Long term Depot Medroxy Progesterone Asetate (DMPA) Injectable Increase Changes in Lipid Profiles of DMPA Injection Contraceptive Acceptors

DMPA injectable contraceptives can cause changes in lipoprotein metabolism. Long term use of DMPA increases triglyceride levels, total cholesterol and LDL and decreases HDL levels. So, it can be concluded that DMPA can cause changes in lipid metabolism which can increase the risk of cardiovascular disease. Changes in fat metabolism occur due to the influence of the hormonal progesterone, which causes disruption of the balance of the lipid profile in the body. The purpose of this study was to determine the effect of using Depo Medroxy Progeserone Acetate injection on the lipid profile of three months injection family planning acceptors based on the duration of use.This research is an analytic observational study with a cross sectional approach, the population in this study were all DMPA family planning acceptors in the work area of ​​the Banjar Sengon Community Health Center, the sampling technique used was total sampling with a sample size of 30. Examination of the lipid profile was carried out by taking blood samples and then measuring them. lipid profile using the enzymatic colorimetric method (cholesterol oxidase method / CHOD PAP). The measurement results obtained were then analyzed using the Independent T test. The results of the T test analysis showed that the P value for cholesterol levels was 0.016 (P &lt;0.05); The p value for triglyceride levels was 0.004 (P &lt;0.05); The p value for HDL levels was 0.046 (P &lt;0.05); The p value for LDL levels was 0.004 (P &lt;0.05).From these data it can be concluded that there is a significant difference in the average levels of cholesterol, triglycerides, HDL, LDL between respondents with a duration of use &lt;3 years and&gt; 3 years. Respondents are expected to carry out routine lipid profile checks to detect early detection of possible abnormalities in lipid profiles that can lead to the risk of heart defects and stroke.

HUBUNGAN LAMA PEMAKAIAN KONTRASEPSI SUNTIK DEPO PROGESTIN DENGAN KENAIKAN BERAT BADAN

Background : Depot Medroxy Progesterone Acetate (DMPA) 150mg or depot progestin is injected every 3 months. This injectable contraceptive is commonly used in Indonesia, according to the BKKBN, there are 2,186,003 (47.65%). Injectable contraceptives have side effects including weight changes. The purpose of this study was to determine the relationship between duration of use of depo progestin injection contraceptives with weight gain in injection acceptors.&#x0D; Research Methods: This type of research uses retrospective analysis. The sampling technique is purposive sampling. The samples studied were all acceptors of depo progestin injections as many as 50 respondents. The data collection technique used a checklist to collect data on contraceptive use and weight gain.&#x0D; Results: Based on data analysis, 30 acceptors (60%) used Depo Progestin contraception for more than 3 years, and 31 acceptors (62%) used Depo Progestin injectable contraception. There is a difference in weight gain between respondents who have used Depo Progestin injection contraceptives for 1 year and used Depo Progestin injection contraceptives for &gt; 1 year. The results obtained by the value of X2count&gt;X2table are 6.848&gt;3.841 with p&lt;0.05, which means that there is a relationship between duration of use of progestin-depo injection contraception and weight gain.&#x0D; Conclusion : There is a significant relationship between duration of use of depo progestin injection contraception and weight gain

The Influence of Three Months Injectable KB of Depo Medroksi Progesteron Acetate (DMPA) on Agency Weight in Tanah Abang Public Health Center, Jakarta, 2019

The most popular method of contraception is injectable contraception. One of the most widely used types of injection kb methods are injectable contraceptives with the type of Noretisterone Enentat (NETEN), Depo Medroxy Progesterone Acetate (DMPA) and Cyclofem. Although widely used, injectable contraceptives have drawbacks. One of the side effects that arise is irregular menstrual patterns such as amenorrhea, menorrhea and spotting, low eversibility, and weight gain of acceptors. Destination:. There is an increase in body weight in mothers, therefore this study aims to determine the relationship between the use of kb injections and maternal weight gain at the Tanah Abang Public Health Center, Jakarta. Methods: This study is an observational analytic study with a case control design to analyze the extent to which risk factors affect The occurrence of an effect in this case is an increase in body weight of the DMPA-type injection family planning acceptors. Result :. Based on the increase in body weight in the case group, 54.2% of DMPA injection family planning acceptors did not show any relative weight gain. However, 59.2% of the DMPA injection family planning acceptor cases experienced weight gain. The increase that occurs between 1 - 2 Kg, further DMPA injection family planning acceptors are at risk of experiencing weight gain 2,310 times faster when compared to non DMPA family planning acceptors. However, KB with the DMPA injection method is not the main factor that causes weight gain, this is indicated by the results of the significance test with Cochran &amp; Mantel Haenszel, the results obtained are X2 count (2.089) &lt;X2 Table (3.841) or p (0.148)&gt; ? (0.050) and CI (0.872; 6.118).

A systematic review on clinical effectiveness, side-effect profile and meta-analysis on continuation rate of etonogestrel contraceptive implant

BackgroundUnintended pregnancies (UIP) have a significant impact on health of women and the health budget of countries. Contraception is an effective way to prevent UIPs. The study objective was to collate evidence on clinical effectiveness of etonogestrel subdermal implant (ESI), continuation rate and side effect profile among eligible women of reproductive age group, as compared to levonorgestrel intrauterine system (LNG-IUS), copper intrauterine device (Cu-IUD) and depot medroxy progesterone acetate injections; other types of contraceptive implants were excluded as comparators.MethodsThe protocol of the systematic review was registered in Prospero (registration number: CRD42018116580). MEDLINE via PubMed, Cochrane library and web of science were the electronic databases searched. A search strategy was formulated and studies from 1998 to 2019 were included. Clinical trial registries and grey literature search was done. Critical assessment of included studies was done using appropriate tools. A qualitative synthesis of included studies was done and a meta-analysis was conducted in RevMan software for continuation rates of ESI as compared to other long acting reversible contraceptives (LARC) e.g. LNG IUS and Cu-IUD.ResultsThe search yielded 23,545 studies. After excluding 467 duplicates, 23,078 titles were screened and 51 studies were included for the review. Eight of the 15 studies reporting clinical effectiveness reported 100% effectiveness and overall pearl index ranged from 0 to 1.4. One-year continuation rates ranged from 57–97%; 44–95% at the end of second year and 25–78% by 3 years of use. Abnormal menstruation was the most commonly reported side effect. There was no significant difference in bone mineral density at 1 year follow-up. The meta-analyses showed that odds ratio (OR) of 1-year continuation rate was 1.55 (1.36, 1.76) for LNG-IUS vs. ESI and 1.34 (1.13, 1.58) for copper-IUD vs. ESI; showing that continuation rates at the end of one-year were higher in LNG-IUS and copper-IUD as compared to ESI.ConclusionESI is clinically effective and safe contraceptive method to use, yet 1-year continuation rates are lower as compared to LNG-IUS and copper-IUD, mostly attributed to the disturbances in the menstruation.

Assessment of family welfare services with respect to couple-years of protection in a primary health center of Varanasi, Uttar Pradesh

Introduction: Program for family welfare or planning is one of the earliest health programs running in Independent India. Budget estimate of Family Welfare Schemes in India for the year 2019–2020 is 950 crores. Despite this, irregularities and under performance of various contraceptive services are reported. Objectives: To assess the family welfare services in a primary health center of Varanasi. Methods: Monthly data of family welfare from April 2018 to March 2019 were collected from PHC and analyzed with permission of Medical Officer in Charge, Chiraigaon. Services were assessed in terms of total family welfare OPD females, total counseling (antenatal case/postnatal case), deliveries, and various methods of contraception. The Couple-years of protection for the individual methods of contraception was calculated. Results: About 51% of females attending clinic were counseled, 40% of females delivering in PHC utilized postpartum intrauterine contraceptive device (PPIUCD). Correlation coefficient between females counseled and parameters such as sterilization varies from weak to strong positive. Two new services Depot Medroxy Progesterone Acetate Antara and oral contraceptive pills Chhaya were introduced, but their availability was not regular. Conclusions: Adequate services for family planning were available, but regularity of few was having issue in the year analyzed. More efforts are required to increase PPIUCD use.

Comparison of Depot Medroxyprogesterone Acetate and Postpartum Intrauterine Contraceptive Device in a Teaching Institute of Rural Bengal: A Longitudinal Cohort Study

Introduction: Contraception is one of the proximate determinants of fertility and the most important predictor of fertility transition. Depot Medroxy Progesterone Acetate (DMPA) and Intrauterine contraceptive device share some common features- both are Long Acting and Reversible Contraceptives (LARC), but the mechanisms are different. DMPA is a noninvasive, hormonal manoeuvre IUCD is an invasive, nonhormonal one. Aim: To compare the acceptance and reasons for refusal or non-compliance between DMPA and Postpartum Intrauterine Contraceptive (PPIUCD). Materials and Methods: A longitudinal cohort study was done in which total of 110 post partum women (55 in each group) using either DMPA or IUCD were selected randomly and were interviewed and followed up for minimum of six months. Data (variables- number of candidates accepting or refusing PPIUCD or DMPA) from the questionnaires were entered in Microsoft Office Excel 2007 and was transferred to IBM SPSS software, version 20.0 (SPSS Inc. Chicago, IL, USA). Pearson’s Chi-square test was used for variables and p-values were calculated using to find out the statistical significance of the variables and p-value &lt;0.05 was considered statistically significant. Results: The overall acceptance of DMPA (87.3%) was found to be much more than that of PPIUCD (63.6%). In respect to different age groups, the acceptances of both PPIUCD and DMPA were significantly higher in women of age group 21-25. In respect to parity, acceptance of PPIUCD was more in women with one child, whereas the acceptances of DMPA were almost similar in women with either one or two children. Women using PPIUCD, 36.4% refused to continue with the method, whereas only 12.7% of DMPA users refused further injections, the main reason for both the groups being the same irregular bleeding. Conclusion: The acceptance as well as compliance of DMPA as a method of postpartum contraception is much better than PPIUCD in women of this part of part of rural Bengal.

The relation of estradiol conditions and usage length to sexual dysfunction in progesterone acetate medroxepo acceptories at Bara-Baraya public health center of Makassar

ObjectiveThis study aims to determine the relationship between estradiol hormone levels and duration of the usage on sexual dysfunction in Depo Medroxy Progesterone Acetate acceptors. MethodFamily Planning (KB/Keluarga Berencana) Depo Medroxy Progesterone Acetate as many as 43 respondents who meet the sample criteria. The sampling technique used was accidental sampling. Data analysis was performed by using chi square. ResultsThe results showed that there was a significant relation between levels of the hormone estradiol and the incidence of sexual dysfunction (p=0.000), as well as the length of time using Depo Medroxy Progesterone Acetate on sexual dysfunction (p=0.000). ConclusionThe result of data analysis is that the duration of Depo Medroxy Progesterone Acetate injection usage significantly reduces the level of the hormone estradiol which can cause sexual dysfunction in Depo Medroxy Progesterone Acetate acceptors.