Depot medroxyprogesterone acetate and basal serum prolactin levels in lactating women

doi:10.1016/S0029-7844(00)01061-9

Obstetrics & Gynecology

Volume 96, Issue 6, December 2000, Pages 926-928

https://doi.org/10.1016/S0029-7844(00)01061-9 Get rights and content

Abstract

Objective: To study the effect of depot medroxyprogesterone acetate on basal serum prolactin levels in lactating women.

Methods: We compared basal serum prolactin levels in 25 lactating women after depot medroxyprogesterone acetate injection and in 25 lactating women of similar age who were using a copper T380A intrauterine device (control group). This sample size was required in order to have 95% power to detect a significant difference. Basal prolactin levels were evaluated by time-resolved fluoroimmunoassay three times (6 weeks postpartum and 3 and 6 weeks after beginning either contraceptive method).

Results: At 6 weeks postpartum, before beginning either contraceptive method, the mean prolactin levels in the study and control groups were 991.31 and 948.75 mU/L, respectively (P = .850, 95% confidence interval [CI] −407.57, 492.70). Three weeks later, the mean prolactin levels in the study and control groups were 1156.12 and 860.10 mU/L, respectively (P = .116, 95% CI −76.20, 668.26). At the last follow-up, the mean prolactin levels in the study and control groups were 1127.83 and 710.97 mU/L, respectively (P = .026, 95% CI 51.97, 781.73). There were no significant within-group differences at 6 weeks postpartum before contraception and at 6 weeks after beginning contraception in the study and control groups (P > .05, 95% CI −327.99, 243.02 and −46.76, 522.33, respectively).

Conclusion: Contraception with depot medroxyprogesterone acetate in lactating women produced higher basal prolactin levels than contraception with copper T380A intrauterine device.

Section snippets

Materials and methods

This study was an open-labeled study. Fifty women 6 weeks postpartum aged 15–40 years who nursed their infants at least 15 minutes five times daily were recruited from the family planning clinic at King Chulalongkorn Memorial Hospital between July 1999 and January 2000. All were healthy and were not taking any medication. They were seen postpartum and requested contraception. Eligible subjects had general medical and gynecologic examinations and were informed about the study. It required that

Results

Table 1 summarizes the distribution of demographic characteristics and factors affecting lactation. There were no statistically significant differences in age, weight, height, or frequency and duration of lactation between groups.

The basal levels of circulating prolactin at 6 weeks postpartum before contraception were not significantly different between groups (Table 2). Three weeks later, mean prolactin levels in the depot medroxyprogesterone acetate group had increased to 1156.12 mU/L,

Discussion

The results of this investigation suggest that the lactating women who received depot medroxyprogesterone acetate had higher basal prolactin levels than the lactating women with a copper T380A IUD, and this effect was more obvious after longer follow-up.

In a previous study, Dicarlo et al4 studied the effect of medroxyprogesterone acetate on serum prolactin levels in mice and found that medroxyprogesterone acetate had no effect on serum prolactin. Moreover, Jeppsson et al5 studied the effect of

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Depot medroxyprogesterone acetate and basal serum prolactin levels in lactating women

Abstract

Section snippets

Materials and methods

Results

Discussion

Contraception

Injectable contraception

Clin Obstet Gynecol

Injected progestogen and lactation

BMJ

The importance of prolactin for lactation in the ewe

J Endocrinol