Comparative acceptability of combined and progestin-only injectable contraceptives in Kenya

• Published in: Contraception (Stoneham) Vol. 72; no. 2; pp. 138 - 145
• Main Authors: Ruminjo, Joseph K., Sekadde-Kigondu, Christine B., Karanja, Joseph G., Rivera, Roberto, Nasution, Marlina, Nutley, Tara
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.08.2005; Elsevier Science
• Subjects: Adult; Biological and medical sciences; Birth control; Contraceptive Agents, Female - administration & dosage; Contraceptives, Oral, Combined - administration & dosage; Cyclofem; Depo-Provera; Estradiol - administration & dosage; Estradiol - analogs & derivatives; Female; Follow-Up Studies; Genital system. Reproduction; Gynecology. Andrology. Obstetrics; Hormonal contraception; Humans; Injectable contraceptives; Medical sciences; Medroxyprogesterone Acetate - administration & dosage; Menstruation Disturbances - chemically induced; Patient Satisfaction; Pharmacology. Drug treatments; Random Allocation; Surveys and Questionnaires; Kenya; Africa; Cyclofem; Depo-Provera; Injectable contraceptives; Human; Menstruation; Monthly; Controlled release form; Estrogen; Intramuscular administration; Progestagen; Medroxyprogesterone; Female; Contraceptive; Cyclotem; Comparative study
• ISSN: 0010-7824; 1879-0518
• DOI: 10.1016/j.contraception.2005.04.001

We compared 12-month continuation rates, menstrual bleeding patterns and other aspects of acceptability between users of Cyclofem and users of Depo-Provera. The life-table method was used to calculate quarterly continuation rates. In all, 360 Kenyan women were randomly assigned to one of the two contraceptives. User-satisfaction questionnaires were administered at 6 and 12 months or at discontinuation, whichever occurred first. The 1-year continuation rate was 75.4% for Depo-Provera users versus 56.5% for Cyclofem users (p<.001). Main reasons for discontinuation included difficulty making clinic visits (45.1% for Cyclofem vs. 40% for Depo-Provera), menstrual changes (14.1% vs. 12.5%) and nonmenstrual problems (15.5% vs. 12.5%). None of the Depo-Provera users and 8.5% of the Cyclofem users claimed frequency of visits as the main reason for discontinuation. In all, 70.6% of the Depo-Provera users were amenorrheic after 12 months, as were 20.8% of the Cyclofem users. The 1-year continuation rate was higher for Depo-Provera than for Cyclofem. There was no important difference in discontinuation rates because of menstrual problems; the difference mainly reflected the frequency of visits required.