Luteinizing hormone releasing hormone agonist for postpartum contraception

Objective: To compare the effects of a GnRH agonist upon ovarian function, bleeding pattern, and nursing practice in two groups of Mexican women during the postpartum period. Design and patients: Two doses of a GnRH agonist (300-600 mu g) were investigated during the postpartum period in fully breastfeeding mothers at 6 weeks postpartum A total of 29 women who desired to breast feed for at least 6 months were allocated in three study groups; group I (control); group II, taking 300 mu g; and group III, taking 600 mu g. Results: After treatment initiation, an increase of estrone levels was observed among treated women; thereafter, irregular fluctuations of estrone levels were observed, mainly among women from group III. All the control women and two participants from group III ovulated during the study. Moderate bleeding was registered in most of the women from group I, while amenorrhea and spotting were observed in participants from groups II and III, respectively. There was no significant effect of the treatment on nursing practice between groups. Conclusion: GnRH agonists have advantages over steroids for hormonal contraception during the postpartum period in breastfeeding women. Symptoms of hypoestrogenism were not reported any time in either the controls or the treated groups, as estrone levels were not suppressed to menopausal values. Once-daily administration of GnRH agonist could be a reliable, acceptable and safe contraceptive method during the postpartum period in breastfeeding women. More information is required to establish GnRH analog contraceptive efficacy.