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Doxycycline in the treatment of bleeding with DMPA: a double-blinded randomized controlled trial

Hany Abdel-Aleem1, Omar M Shaaban, Mahmoud A Abdel-Aleem

  • 1Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Egypt. aleemh@yahoo.com

Contraception
|February 14, 2012
PubMed
Abstract

Insights

Doxycycline (DOX) did not effectively stop bleeding episodes in women using depot medroxyprogesterone acetate (DMPA) injectable contraception. This matrix metalloproteinase inhibitor also showed no improvement in bleeding patterns over three months.

Area of Science:

  • Reproductive Endocrinology
  • Pharmacology
  • Gynecology

Background:

  • Abnormal uterine bleeding is a common side effect of depot medroxyprogesterone acetate (DMPA) injectable contraception.
  • Increased endometrial matrix metalloproteinase (MMP) activity is linked to DMPA-induced bleeding.
  • Doxycycline (DOX), an MMP inhibitor, was investigated for its potential to manage this bleeding.

Purpose of the Study:

  • To evaluate the efficacy of doxycycline in treating acute bleeding episodes in women using DMPA.
  • To assess the impact of doxycycline on bleeding patterns over a three-month period following treatment.

Main Methods:

  • A double-blinded, randomized controlled trial was conducted with DMPA users experiencing bleeding.
  • Participants received either 100 mg doxycycline twice daily for 5 days or a placebo.
  • Bleeding and spotting days were recorded in diaries, with a 3-month follow-up period.

Main Results:

  • Doxycycline showed no significant difference compared to placebo in stopping bleeding episodes within 10 days (Relative Risk: 0.88, CI: 0.64-1.21).
  • No significant improvement in the number of bleeding and/or spotting days was observed in the three months post-treatment for the doxycycline group versus placebo.

Conclusions:

  • Doxycycline is not effective in managing acute bleeding associated with DMPA use.
  • Doxycycline does not improve subsequent bleeding characteristics in women using DMPA contraception.

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