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Effect of Supplementary Oral Estrogen on Long-Acting Injectable Progestogen Contraception

MOUSTAFA ALY EL-HABASHY, MD^*,, DANIEL R. MISHELL, Jr., MD, FACOG¹ and DEAN L. MOYER, MD, FACOG¹

¹From the Division of Reproductive Biology and the Departments of Obstetrics and Gynecology and Pathology, Harbor General Hospital, Torrance, Calif, and the UCLA School of Medicine, 2025 Zonal Ave, Los Angeles, Calif. 90033
*Ford Foundation Fellow in Reproductive Biology
Department of Obstetrics and Gynecology, Alexandria University School of Medicine, Alexandria, Egypt, UAR

Abstract

Continuous daily oral administration of 1 mg of stilbestrol during the 3 months following the first injection of the contraceptive, depo-medroxy-progesterone acetate, 150 mg, failed to diminish the incidence of uterine bleeding when compared with controls. Such supplemental estrogen did not significantly alter the appearance of endometrial biopsies or karyopyknotic indices. Cyclic administration of supplemental oral estrogen for 3 weeks of a 4-week period caused regular withdrawal uterine bleeding. It was concluded that there is little advantage in giving supplemental oral estrogen to patients using long-acting injectable progestogen for contraception.