Abstract
Study Objective
The aim of this study was to review the efficacy of different medical modalities for
menstrual suppression in the cohort of patients with disabilities who presented to
the Queensland Paediatric and Adolescent Gynaecology (PAG) Service between January
2005 and December 2015. Menstrual suppression in adolescents with disabilities is
an important aspect of care to support the patient and their carers in managing the
complexities of menstrual hygiene, pain, and other discomfort associated with menses.
It is important for general practitioners, pediatricians, and gynecologists to establish
the right modality of suppression for each individual adolescent.
Design, Settings, Participants, Interventions, and Main Outcome Measures
The study was a retrospective case notes review of 68 adolescents who presented to
the Queensland PAG Service, Brisbane, Australia with a request for menstrual suppression.
The medical interventions included treatment with either combined oral hormonal contraceptive,
oral medroxyprogesterone, depot medroxyprogesterone, or the levonorgestrel intrauterine
system (Mirena, Bayer). The primary outcome measure was success of menstrual suppression
from commencement of medical intervention to achievement of complete amenorrhea or
very light bleeding described as spotting, for each medical modality. Secondary outcomes
were length of time from first treatment to first observed menstrual suppression,
and the number of outpatient appointments taken to achieve menstrual suppression.
Results
Of the 68 adolescents, 59/68 (86.8%) successfully achieved menstrual suppression,
with 9/68 (13.2%) having ongoing treatment or loss to follow-up at the time of conclusion
of the study; 39/68 (57.4%) were menstrually suppressed with their chosen medical
modality after their initial appointment.
Conclusion
Medical modalities are highly effective in achieving menstrual suppression and no
young women at this institution required a hysterectomy. Depot medroxyprogesterone
was the most successful modality used to achieve menstrual suppression followed by
the levonorgestrel intrauterine system. The combined oral hormonal contraceptive was
the least successful medical treatment in achieving menstrual suppression.
Key Words
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Article info
Publication history
Published online: June 07, 2019
Footnotes
The authors indicate no conflicts of interest.
Identification
Copyright
Crown Copyright © 2019 Published by Elsevier Inc. on behalf of North American Society for Pediatric and Adolescent Gynecology. All rights reserved.
