comparison of continuation rates and reasons of discontinuation for cyclofem and depot -medroxyprogesterone acetate in rural areas of east azerbaijan province, iran

Objective: In this study continuation rate and reasons for discontinuation of Depot-medroxyprogestrone
acetate (DMPA)and Cyclofem have been compared.
Materials and methods: A retrospective cohort study was conducted with 422 women (202 Cyclofemand
220 DMPA users)who had started using the methods 12-24 months before the study in East Azerbaijan
health houses. Data were collected by reviewing the records and interview with the clients and analysed
using Kaplan-Meier and Cox Regression.
Results: The 3, 6, 9, 12 months continuation rate were 56%, 37%, 30%, 27% respectively for Cyclofem
versus 75%, 59.5%, 48%, 42.5% for DMPA. Menstrual changes were reported significantly more by the
DMPA users than the Cyclofem users (85% vs. 73%, P=0.008) as the main reason for the
discontinuation, the difference mainly reflected of amenorrhea (50% vs. 23%, P=0.003). None of DMPA
users and 11% of Cyclofem users claimed frequency of visits and lack of method supplies as their main
discontinuation reason.
Conclusion: Discontinuation rate was high for the both methods but it was higher for Cyclofem.The
common side effects mentioned as the main reasons for discontinuation of the both methods are not
health threatening. Therefore, health care providers may help to improve their continuation rate by
appropriate consultation.