Comparison of Continuation Rates and Reasons of Discontinuation for Cyclofem Depo -Provera in Rural Areas if East Azerbaijan Province, Iran, 2009.

Abstract

Abstract: Background: Depo –provera and Cyclofem are only available injectable methods in Iran that are used by 2.6% of married women of reproductive age. Cyclofem has been provided by the public health system since 2007. In Iran there was no study about continuation of Cyclofem, and all of published studies about Depo –provera in Iran were in urban areas. The aim of this study is to compare continuation rate and reasons of discontinuation of Depo –provera and Cyclofem in rural areas of Iran. Methods: A retrospective cohort study was conducted with 422 women who had been started getting Cyclofem (200 women) or Depo –provera (220 women) from selected East Azerbaijan health house 12-24 month before data collection. Data were collected by interview and review of records using a questionnaire and were analyzed by SPSS13 using X2 Kaplan Mayer, Cox Regression and Independent t test. Results: The mean of the subjects was 33(SD=7). One tenth of them had high school education or higher. The 3, 6, 9 and 12 months continuation rate were 56%, 37%, 30% and 27% for Cyclofem versus 75%, 59%, 48% and 42% for Depo –provera. Menstrual changes (as a combined reason) in the both groups (72% for Cyclofem versus 84.5% for Depo -provera) with amenorrhea (as an individual reason) (22% for Cyclofem versus 50% for Depo –provera) were the most common reasons for discontinuation but their frequencies were significantly higher in the Depo –provera group (p<0.001). Conclusion: Continuation rate for Cyclofem was significantly lower than Depo –provera and frequencies of menstrual changes as the most common reason for discontinuation in the Depo –provera group were higher than Cyclofem group, However continuation rate was lower for the both methods compared with studies in other countries, but similar to other studies menstrual changes specially amenorrhea and spotting were main reasons for their discontinuations that are not health threatening effects, health providers should help to improve the continuation rate by appropriate consultation.