The Rate and Predictors of Abnormal Vaginal Bleeding Among Three Progesterone-Only Contraceptive Users: A Longitudinal Study

Objectives: To identify the rate and predictors of abnormal uterine bleeding (AUB) related to the 1-year use of three progestin-only contraceptive methods (POCs).Study Design: The study was a single-center 12-month longitudinal study.Patients and Methods: It was conducted at Assiut Woman's Health Hospital; Egypt from the 1st of August 2018 to the 1st of August 2020 included women who wanted to use depot medroxyprogesterone acetate 150 mg injection (DMPA), etonogestrel (ENG) implant, or desogestrel pills for pregnancy prevention for at least 1 year. The rate of AUB associated with these methods during 1 year of use and the potential predictors associated with this bleeding were the study outcomes. The data was analyzed using a t-test, ANOVA test, Mann–Whitney U test, Chi-square, Fisher exact test, and multivariate logistic regression test.Results: Three hundred and ninety women were included in the study. The rate of AUB during 1 year in the DMPA, ENG implant, and desogestrel pills group was 59.2%, 60.2%, and 53.2%; respectively. The predictive model found that high parity (cut-off >3), lactating women, women with AUB with previous hormonal contraception use, and women with a higher uterine volume (cut-off >42 ml) were significant predictors.Conclusion: The ENG implant has a higher rate of AUB during 1 year of use followed by the DMPA group and desogestrel pills. The woman should be counseled if she is at risk for developing AUB during the first year of POCs use hopping to increase the continuation and satisfaction rate.