Abstract
Objectives
We aimed to determine the efficacy of fennel and low-dose combined oral contraceptive
(LD-COC) on inducing menstrual bleeding and method continuation in women using depot
medroxyprogesterone acetate (DMPA) who had no menstrual bleeding within the previous
45 to 140 days.
Study design
In this double-blind double-dummy trial, 78 married women referred to public health
centers in Hamadan, Iran, who complained of menstrual cessation induced by DMPA were
randomly assigned into fennel, LD-COC or placebo groups with an allocation ratio of
1:1:1. All participants received two fennel or placebo capsules and one placebo or
LD-COC pill daily for 21 days. We evaluated menstrual bleeding using the Higham pictorial
chart within 40 days following initiating intervention. Data were analyzed using chi-square
or analysis of variance.
Results
There was no loss to follow-up. Significantly more women in the fennel (73%) and LD-COC
(81%) groups experienced menstrual bleeding compared to the placebo (19%) group [relative
risk (RR) 3.1, 95% confidence interval (CI) 1.6 to 6.2; RR 4.2, 95% CI 1.9 to 9.4,
respectively]. Mean amount of menstrual bleeding among those who experienced menstruation
was significantly higher in the fennel group (21 cc) than both the LD-COC (14 cc)
and placebo (12 cc) groups. Also, women using fennel (73%) and LD-COC (65%) were significantly
more likely than those using placebo (31%) to have subsequent DMPA injection [RR 2.5
(95% CI 1.3 to 4.9) and RR 2.0 (95% CI 1.1 to 3.7), respectively].
Conclusions
Fennel and LD-COC can resolve DMPA-induced amenorrhea and increase continuation rate
of this contraceptive method.
Keywords
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Article info
Publication history
Published online: May 14, 2014
Accepted:
May 5,
2014
Received in revised form:
April 26,
2014
Received:
January 22,
2014
Footnotes
☆Funding: Research Deputy of Tabriz University of Medical Sciences.
☆☆Implication: Both fennel and combined oral contraceptives, used for 21 days, could treat amenorrhea induced by depot medroxyprogesterone acetate and increase the rate of subsequent injection in women dissatisfied with the menstrual cessation. Using the approaches in such condition may prolong continuation of use of this highly effective method which may result in reducing the rate of unintended pregnancies.
★Clinical trial registration number: IRCT201205013706N12.
Identification
Copyright
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