Assessing Menopausal Status in Women Aged 40-49 Using Depot-Medroxyprogesterone Acetate, Norethisterone Enanthate Or Combined Oral Contraception (Original Articles) (Report)

Assessing Menopausal Status in Women Aged 40-49 Using Depot-Medroxyprogesterone Acetate, Norethisterone Enanthate Or Combined Oral Contraception (Original Articles) (Report)

Determining the onset of menopause in older users of hormonal injectable contraceptives depot medroxyprogesterone acetate (DMPA) and norethisterone enanthate (NET-EN) can be challenging. These contraceptive methods may mask menopausal symptoms such as amenorrhoea, which is a common side-effect of the method itself and increases in incidence over length of time used. (1) DMPA has been shown to relieve vasomotor symptoms in perimenopausal women. (2, 3) Furthermore, DMPA and NET-EN are known to suppress the midcycle surge of follicle-stimulating hormone (FSH) and luteinising hormone (LH), thereby reducing raised FSH levels, although the tonic release of these gonadotrophins continues at luteal phase levels. (4) Detection of menopause or perimenopause may, therefore, present difficulties in this group of contraceptive users. In older combined oral contraceptive (COC) users, it is recommended that FSH is measured on the seventh day of the pill-free interval. (5) However, appropriate advice for DMPA and NET-EN users is less clear, and it has been suggested that the options are to continue using the method until the woman reaches 55 years or to change to a non-hormonal method of contraception. (6)

Assessing Menopausal Status in Women Aged 40-49 Using Depot-Medroxyprogesterone Acetate, Norethisterone Enanthate Or Combined Oral Contraception (Original Articles) (Report)

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