Frequency of menstrual disorders with depot medroxy progesterone acetate [DMPA] as contraceptive

Increasing population growth rate in developing countries like Pakistan is a major problem requiring fertility control. The introduction of injectable hormonal contraceptives has increased the number of women practicing contraception and compliance as well. To assess the frequency of menstrual disorders with depot medroxy progesterone acetate. This descriptive study was carried out in Obstetrics and Gynaecology Unit I, in collaboration with Reproductive Health Services, Master Training Centre, Nishtar Hospital Multan during the period from July 2005 to December 2006. One hundred and fifty non-pregnant women of reproductive age were selected and after complete history, examination and investigations, all women suitable for DPMA were included. In our Study the main complaint was menstrual disturbance. More than one fifth of the clients i.e. 32 [21%] enjoyed normal menstrual patterns. Sixty two [41%] ladies developed amenorrhoea by the end of one year. Seventeen [12%] cases complained of irregular vaginal bleeding and 39 [26%] had heavy regular periods. One hundred and thirty three [89%] patients revealed complete satisfaction with the product while 17 [11%] complained about discomfort due to menstrual problems. Out of these seventeen, nine discontinued as menstrual irregularities had handicapped their life so there were 141 [94%] patients who continued while 6% discontinued. Despite bleeding disturbances caused by DPMA, high continuation rates showed that this contraceptive method is acceptable to women

Polycystic ovarian disease; the diagnosis and management

Poly Cystic Ovarian Disease [PCOD] is probably one of the most common endocrinological disorders amongst the women during their reproductive years. Using USG criteria only 20-33% of apparently healthy women in childbearing period, have been found to have PCOD in population study. Whereas prevalence of 4-10% in women of reproductive age is commonly reported when the diagnosis is based on clinical, biochemical and US scan features. Diagnosis and management of polycystic ovarian disease. Setting Seyal Medical Centre, Multan. Duration From January 2002 to December 2003. Sample size: 200 patients. Most of he patients were in the age group of 21-30 years. The youngest patient was of 17 years and eldest was of 42 years. Majority of the women were nulliparous or of low parity comprising 92% of cases. The commonest symptom was menstrual disorder in 168 Patients [84%]. Ultrasound is very helpful for diagnosis of POD. i. About 80% of patients were diagnosed as PCOD on ultrasound. There is increased level of LH in 72% patients, 8% have raised prolactin levels. All patients were first treated with clomiphene citrate while surgical treatment is done n only 30% of cases. GnRH analogue and purified FSH were not used because they are quite expensive. PCOD is found to be one of the commonest problem in reproductive years of life. Clomiphene citrate is first line treatment in PCOD for infertility. Laparoscopic drilling has very good results especially in clomiphene resistant cases