Objective: To determine whether serum estradiol (E2) level was low after Depot-medroxyprogesterone (DMPA) induced amenorrhea for contraception, thus to evaluate the safety of using DMPA.
Methods: Forty four Chinese women with amenorrhea after injecting DMPA were investigated, and the median period of amenorrhea was 18 months. Symptoms, pelvic examination, serum E2 and follicular stimulating hormone (FSH) levels, and vaginal cytology were examined.
Results: Women with amenorrhea had neither symptoms nor genital atrophy that similar to menopausal syndrome. The median level of serum E2 was 150.5 pmol/L (equal to the level of early follicular phase), and the median level of serum FSH was 14.0 IU/L. There were no correlation between E2 and FSH levels, and no correlation between amenorrhea period and E2 or FSH levels (P > 0.05) as well. No significant relationship between estrogen effects by vaginal cytology and the time period of amenorrhea was found. However, the estrogen effect was significantly correlated to the interval from last injection to vaginal smear tested.
Conclusion: It could be concluded that though DMPA may induce amenorrhea, it will not lower serum E2 levels, and the inhibition of ovarian function is reversible.