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Treatment of vaginal bleeding irregularities induced by progestin only contraceptives

Overview of attention for article published in Cochrane database of systematic reviews, October 2013
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Mentioned by

policy
1 policy source

Citations

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36 Dimensions

Readers on

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140 Mendeley
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Title
Treatment of vaginal bleeding irregularities induced by progestin only contraceptives
Published in
Cochrane database of systematic reviews, October 2013
DOI 10.1002/14651858.cd003449.pub5
Pubmed ID
Authors

Hany Abdel‐Aleem, Catherine d'Arcangues, Kirsten M Vogelsong, Mary Lyn Gaffield, A Metin Gülmezoglu

Abstract

Despite their high effectiveness, progestin-only contraceptives are considered less than ideal by the many women who experience irregular vaginal bleeding when using them. Current treatments to control these bleeding problems are not sufficiently effective. We evaluated preventive and therapeutic approaches to normalise bleeding irregularities associated with the use of progestin-only contraceptives. Literature was identified through database searches, reference lists, organisations and individuals, covering the period until May-June 2012. Trials with random or systematic allocation, testing interventions for the prevention or treatment of bleeding irregularities associated with the use of progestin-only contraceptives were eligible. Results are expressed as relative risks (RR) with 95% confidence interval (CI) for categorical data and as weighted mean difference (WMD) with 95% CI for continuous data. When we encountered heterogeneity (visual or statistical) we used the random-effects model (quantitative) or did not produce a summary estimate (qualitative). Thirty-three randomised controlled trials enrolling 3677 participants were included. Two thirds of the trials were determined to reflect low to moderate risk of bias.Estrogen treatments reduced the number of days of an ongoing bleeding episode in DMPA and Norplant users. However, treatment frequently led to more discontinuation due to gastrointestinal upset.Combinations of oral ethinyl estradiol and levonorgestrel improved bleeding patterns in Norplant users, but method discontinuation rates were unchanged. One trial reported successful use of combined oral contraceptives in treating amenorrhea among DMPA users.Norplant users, but not Implanon users, administered the anti-progestin mifepristone reported fewer days of bleeding during treatment than those given placebo. Mifepristone used monthly by new Norplant acceptors reduced bleeding, when compared to placebo.A variety of NSAIDS have been evaluated for their ability to treat abnormal bleeding, with mixed results.Norplant users receiving SERM (tamoxifen) had less unacceptable bleeding after treatment and were more likely to continue using Norplant than those receiving placebo.Tranexamic acid, mifepristone combined with an estrogen and doxycycline were more effective than placebo in terminating an episode of bleeding in women using progestin-only contraceptives, according to three small studies. Some women may benefit from the interventions described, particularly with cessation of current bleeding. Several regimens offer promise in regulating bleeding, but findings need to be reproduced in larger trials. The results of this review do not support routine clinical use of any of the regimens included in the trials, particularly for long-term effect.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 140 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 140 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 15 11%
Student > Bachelor 13 9%
Student > Postgraduate 12 9%
Student > Master 12 9%
Student > Ph. D. Student 10 7%
Other 22 16%
Unknown 56 40%
Readers by discipline Count As %
Medicine and Dentistry 50 36%
Nursing and Health Professions 12 9%
Social Sciences 4 3%
Biochemistry, Genetics and Molecular Biology 3 2%
Pharmacology, Toxicology and Pharmaceutical Science 3 2%
Other 9 6%
Unknown 59 42%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 April 2014.
All research outputs
#8,571,053
of 25,457,858 outputs
Outputs from Cochrane database of systematic reviews
#9,070
of 11,499 outputs
Outputs of similar age
#76,550
of 224,562 outputs
Outputs of similar age from Cochrane database of systematic reviews
#166
of 212 outputs
Altmetric has tracked 25,457,858 research outputs across all sources so far. This one is in the 43rd percentile – i.e., 43% of other outputs scored the same or lower than it.
So far Altmetric has tracked 11,499 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 40.0. This one is in the 15th percentile – i.e., 15% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 224,562 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 49th percentile – i.e., 49% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 212 others from the same source and published within six weeks on either side of this one. This one is in the 16th percentile – i.e., 16% of its contemporaries scored the same or lower than it.