Double-Dose Desogestrel: Is it Effective in Adolescent Menstrual Dysfunction?

Adolescent menstrual dysfunction (AMD) is a common cause of iron deficiency anemia and absences from school. The management of AMD with single- and double-dose desogestrel is largely on the basis of anecdotal evidence. Our aim was to describe the effectiveness and safety of both dosing strategies in our clinic cohort to help guide future management.

Local service evaluation with retrospective analysis of clinic notes.

Adolescent gynecology clinic in a tertiary pediatric center in the North West of England.

Adolescent girls (10-18 years of age) with AMD (n = 129).

Single-dose (75 µg) desogestrel vs double-dose (150 µg) desogestrel.

Prevalence of amenorrhea and light spotting, side effects, and discontinuation rates of both dosing regimens.

Forty-three of 87 (49%) adolescent girls who started treatment with a double dose of desogestrel were amenorrheic/experienced light spotting, compared with 7/40 (18%) of girls who started treatment with a single dose (P = .001). Patients taking a double dose of desogestrel were less likely to discontinue overall (double: 45/89 [51%]; vs single: 35/40 [88%]; P < .001) and there was no evidence of an increase in nonbleeding side effects (double: 30/89 [34%]; vs single: 15/40 [38%]; P = .68).

Our findings provide evidence that a double dose of desogestrel is associated with a higher prevalence of amenorrhea and light spotting compared with a single dose in adolescent girls with AMD. However, larger studies are needed to further inform clinical guidelines.