Effects of Depot Medroxyprogesterone Acetate Intramuscular Injection, Copper Intrauterine Device and Levonorgestrel Implant Contraception on Estradiol Levels: An Ancillary Study of the ECHO Randomized Trial.
contraception
copper intrauterine device
depot medroxyprogesterone acetate
estradiol
levonorgestrel implant
randomized trial
Journal
Frontiers in global women's health
ISSN: 2673-5059
Titre abrégé: Front Glob Womens Health
Pays: Switzerland
ID NLM: 101776281
Informations de publication
Date de publication:
2022
2022
Historique:
received:
01
03
2022
accepted:
25
04
2022
entrez:
7
6
2022
pubmed:
8
6
2022
medline:
8
6
2022
Statut:
epublish
Résumé
Hormonal contraception affects endogenous sex steroid levels. Robust evidence from randomized trials of the relative effects of different contraceptive methods is scarce. We compared the effects of three contraceptive methods on serum estradiol levels using data from women (18-35 years) requesting contraception in the Evidence for Contraceptive Options and HIV Outcomes (ECHO) randomized trial. Women were randomly allocated to the depot medroxyprogesterone acetate intramuscular (DMPA-IM) injection, copper intrauterine device (IUD) or levonorgestrel (LNG) implant. In this sub-study, stored baseline and 6-month serum samples were analyzed in 401 participants from East London, South Africa (DMPA-IM: 131, IUD: 135 and LNG: 135). Baseline median (interquartile range, IQR) estradiol levels were similar between the three groups [DMPA-IM 229 (152-455), IUD 235 (168-426) and LNG 216 (153-419 pmol/L)]. At 6-months, median estradiol in the IUD group was unchanged (298 (163-467) pmol/L), whilst levels in the DMPA-IM and implant groups were significantly reduced from baseline. The median estradiol level in the DMPA-IM group [139 (97-193) pmol/L] was significantly lower than in both IUD ( At 6-months (DMPA-IM nadir), median estradiol with DMPA-IM was 53% lower and with the LNG implant, 48% lower than with the IUD. The greater reduction in estradiol levels with the DMPA-IM injection compared to the LNG implant and IUD has implications for the relative psychological, sexual as well as physiological side-effects of these contraceptive methods. ClinicalTrials.gov, identifier: NCT02550067.
Identifiants
pubmed: 35669313
doi: 10.3389/fgwh.2022.887541
pmc: PMC9163398
doi:
Banques de données
ClinicalTrials.gov
['NCT02550067']
Types de publication
Journal Article
Langues
eng
Pagination
887541Informations de copyright
Copyright © 2022 Ryan, Mussa, Singtaa-Madliki, Batting, Balakrishna, Morroni and Hofmeyr.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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