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Evidence summaries

Steroid Hormones for Contraception in Women with Sickle Cell Disease

Depo-medroxyprogesterone acetate may be a safe contraceptive option for women in SS disease. In addition to providing effective contraception, DMPA may reduce sickle pain crises. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 1 study with a total of 25 subjects. Patients were randomized to three monthly depo-medroxyprogesterone acetate (DMPA) or intramuscular saline placebo injections in a crossover design. A six-month washout period was implemented before the crossover; however, pharmacological evidence indicates that levels of DMPA may be detected for more than 200 days after the injection. During DMPA use, women were less likely to experience painful sickle episodes (OR 0.23; 95% CI 0.05 to 1.02). No trial involved estrogen products.

Comment: The quality of evidence is downgraded by study quality (inadequate allocation concealment and by imprecise results) few studied patients.

    References

    • Manchikanti A, Grimes DA, Lopez LM, Schulz KF. Steroid hormones for contraception in women with sickle cell disease. Cochrane Database Syst Rev 2007 Apr 18;(2):CD006261 [Review content assessed as up-to-date: 31 October 2011]. [PubMed]

Primary/Secondary Keywords