Document Detail


Introduction of cyclofem once-a-month injectable contraceptive in Mexico.
MedLine Citation:
PMID:  9743890     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A large introductory study of Cyclofem, a once-a-month injectable contraceptive, was conducted in three Mexican provinces. A total of 3457 healthy women participated: 640 women from rural areas (community-based component) and 2817 women from urban and suburban areas (health center-based component). A total of 20,316 women-months of treatment experience were accumulated during a one year period. Cyclofem proved its use-effectiveness (pregnancy rate of 0.03%) and its safety under routine service conditions of family planning facilities in Mexico. The overall life table continuation rate at 1 year was 26.1%. Higher continuation rates were observed in the community-based component (36.6%) as compared to the health center component (23.7%). The most common reason for method discontinuation was change of address. Only 15% of the discontinuations were attributable to the injectable contraceptive method, with the overall 1 year discontinuation rate for bleeding problems (including amenorrhea) was < 11%. These observations underscore the importance of appropriate counseling and follow-up measures, providing convenient access to repeat injections, and other service delivery issues related to continuation of Cyclofem. The results of this trial have once again demonstrated that Cyclofem is a highly effective method with an acceptable side effect profile. In addition, the study provided the elements for its approval by local health authorities and its inclusion into the Ministry of Health Family Planning Program.
The effectiveness and continuation rates associated with the once-a-month injectable contraceptive Cyclofem were investigated in an introductory trial conducted in three Mexican provinces (Sinaloa, Guanajuato, and Veracruz). Cyclofem contains 25 mg of medroxyprogesterone acetate and 5 mg of estradiol cypionate. A total of 3457 women (640 women from rural communities and 2817 from urban and suburban family planning centers) were enrolled and 20,316 woman-months of treatment experience were accumulated during the 12-month study period. The mean age of study participants was 23.6 years; 70% had previously used at least one contraceptive method. There was only one pregnancy (rate, 0.03%). The overall life-table continuation rate at 1 year was 26.1%, but this rate was higher in the community-based group (36.9%) than in the health center group (22.4%). This discrepancy is presumed to reflect the greater access of clinic clients to other contraception options. Continuation was highest among women 30-34 years of age, those with low levels of education, women with five or more children, and those who did not want more children. Only 14% of discontinuations were method-related. The 1-year discontinuation rate for bleeding problems, including amenorrhea, was 10.2%. These findings indicate Cyclofem is a safe, effective method appropriate for inclusion in Mexico's Ministry of Health Family Planning Program.
Authors:
J Garza-Flores; A Moraks del Olmo; J L Fuziwara; J G Figueroa; A Alonso; J Monroy; M Perez; M Urbina-Fuentes; S J Guevara; E Cedeno; R Barrios; J J Ferman; L M Medina; E Velazquez; G Perez-Palacios
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Contraception     Volume:  58     ISSN:  0010-7824     ISO Abbreviation:  Contraception     Publication Date:  1998 Jul 
Date Detail:
Created Date:  1998-11-24     Completed Date:  1998-11-24     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  0234361     Medline TA:  Contraception     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  7-12     Citation Subset:  IM; J    
Affiliation:
Departmento de Biologia de la Reproduccion, Instituto Nacional de la Nutricion Salvador Zubirõn, México D.F.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Contraceptive Agents, Female*
Contraceptives, Oral, Combined / administration & dosage,  adverse effects
Educational Status
Estradiol / administration & dosage,  adverse effects,  analogs & derivatives*
Female
Humans
Injections, Intramuscular
Medroxyprogesterone Acetate / administration & dosage*,  adverse effects
Mexico
Patient Satisfaction
Prospective Studies
Chemical
Reg. No./Substance:
0/Contraceptive Agents, Female; 0/Contraceptives, Oral, Combined; 50-28-2/Estradiol; 71-58-9/Medroxyprogesterone Acetate; 71615-27-5/CycloProvera

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