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The test is performed by administering a progestogen, such as progesterone either as an intramuscular injection or oral medroxyprogesterone acetate (Provera). If the patient has sufficient serum estradiol (greater than 50 pg/mL), withdrawal bleeding should occur 2–7 days after the progestin is withdrawn, indicating that the patient's ...
DMPA, under brand names such as Depo-Provera and Depo-SubQ Provera 104, is used in hormonal birth control as a long-lasting progestogen-only injectable contraceptive to prevent pregnancy in women. [ 38 ] [ 39 ] It is given by intramuscular or subcutaneous injection and forms a long-lasting depot , from which it is slowly released over a period ...
Hormonal therapies to reduce or stop menstrual bleeding have long been used to manage a number of gynecologic conditions including menstrual cramps (dysmenorrhea), heavy menstrual bleeding, irregular or other abnormal uterine bleeding, menstrual-related mood changes (premenstrual syndrome or premenstrual dysphoric disorder), and pelvic pain due to endometriosis or uterine fibroids.
During the week of placebo pills, withdrawal bleeding occurs and simulates an average 28-day menstrual cycle. The placebo pills are not required for pregnancy protection, and with any monophasic COCP the placebo pills may be discarded, and the next pack of active pills may be started to prevent the withdrawal bleeding. [ 10 ]
Changes in menstrual bleeding may occur, such as a lighter flow or complete stop to the regular monthly menses, or abnormal bleeding throughout the cycle. Others have reported small weight gain, and increase in headaches or mood swings, and a decrease in libido. [6]
Hormonal contraceptives can come in multiple forms including injectables. Depot medroxyprogesterone acetate (DMPA), a progestin-only injectable, has been found to cause amenorrhea (cessation of menstruation); however, the irregular bleeding pattern returns to normal over time. [15] [16] DMPA has also been associated with weight gain. [16]
The withdrawal bleeding that occurs during the break from active pills has been thought to be reassuring, a physical confirmation of not being pregnant. [48] The withdrawal bleeding is also predictable. Unexpected breakthrough bleeding can be a possible side effect of longer term active regimens. [49]
Progestogens such as norethisterone acetate and medroxyprogesterone acetate may be used to artificially induce progesterone-associated breakthrough bleeding. [27] The progestogen challenge test or progestogen withdrawal test is used to diagnose amenorrhea. Due to the availability of assays to measure estrogen levels, it is now rarely used.