SummaryNorethisterone ethanate (200 mg every 84 days) and medroxyprogesterone acetate (150 mg every three months) were found to be completely effective in fertility control when started in the puerperium. Neither agent had any ill effect on the amount of milk or the duration of lactation. From the third month onward the three-hourly available milk and the infant weight gain per month were statistically higher in treated groups than in controls. Milk proteins showed a slight decrease in most groups, including the controls, owing to the low-protein diet.No important side effect was produced by these agents other than amenorrhoea.
Depot Medroxy Progesterone Acetate 150 mg every 3 months was given to 231 women followed through 4 671 woman/months. The same progestogen in 300 mg dosage was given as six‐monthly injections to 92 women followed through 904 woman/months. These two dosage schedules were 100% effective in fertility control, the crude drop out rate reached 33.7% and 51.0% respectively. The menstrual cycles were markedly disorganized. The re‐establishment of normal menstrual and endometrial cycles and fertility after stopping therapy was reported. The effects on the genital organs, glucose tolerance, thyroid and liver function tests were studied.
Summary
Ovarian tissue was studied from 19 women who developed prolonged amenorrhoea (6–21 months) after Depomedroxyprogesterone acetate or norethisterone enanthate injections for contraception for 18 to 33 months. The ovarian specimens were obtained in 11 of the patients during progestogen medication and in the other eight 2 to 6 months after stopping treatment. In four cases withdrawal bleeding was induced by oestrogen before examination of the ovaries.
The ovarian tissue showed either follicular suppression, when only primordial follicles were detected, or a multicystic pattern with many non‐luteinized cystic follicles or follicular cysts in different stages of development and degeneration. This multicystic pattern was seen mainly in women with amenorrhoea persisting after stopping therapy. Oestrogen administration to induce withdrawal bleeding produced no change in the ovary other than increased congestion.
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