GnRH agonist for postpartum contraception: biochemical, hormonal and endometrial effects.

OBJECTIVE: To determine whether GnRH agonist administration induces changes in biochemical, hormonal and endometrial parameters in breastfeeding women. DESIGN AND PATIENTS: Starting at 6 weeks postpartum, fully breastfeeding mothers began treatment with GnRH agonist, receiving 300 micrograms and 600 micrograms per day by nasal spray for 6 months. A third group of breastfeeding women who were users of IUDs served as controls. Eighteen biochemical analyses were quantified in serum. Blood samples were collected at 0, 3 and 6 months after treatment and endometrial biopsies were obtained at 0 and 6 months. No other method of contraception was employed. RESULTS: Interindividual and intergroup differences were observed in clinical chemistry. According to the hormonal levels and the histopathologic analysis, various grades of follicular activity were found in the treated groups. No pregnancies occurred. CONCLUSION: Because GnRH agonist treatment had no significant deleterious effects on the parameters studied, this treatment could represent a feasible and safe approach to postpartum contraception.

Luteinizing hormone releasing hormone agonist for postpartum contraception.

OBJECTIVE: To compare the effects of a GnRH agonist upon ovarian function, bleeding pattern, and nursing practice in two groups of Mexican women during the postpartum period. DESIGN AND PATIENTS: Two doses of a GnRH agonist (300-600 micrograms) were investigated during the postpartum period in fully breastfeeding mothers at 6 weeks postpartum. A total of 29 women who desired to breast feed for at least 6 months were allocated in three study groups; group I (control); group II, taking 300 micrograms; and group III, taking 600 micrograms. RESULTS: After treatment initiation, an increase of estrone levels was observed among treated women; thereafter, irregular fluctuations of estrone levels were observed, mainly among women from group III. All the control women and two participants from group III ovulated during the study. Moderate bleeding was registered in most of the women from group I, while amenorrhea and spotting were observed in participants from groups II and III, respectively. There was no significant effect of the treatment on nursing practice between groups. CONCLUSION: GnRH agonists have advantages over steroids for hormonal contraception during the postpartum period in breastfeeding women. Symptoms of hypoestrogenism were not reported any time in either the controls or the treated groups, as estrone levels were not suppressed to menopausal values. Once-daily administration of GnRH agonist could be a reliable, acceptable and safe contraceptive method during the postpartum period in breastfeeding women. More information is required to establish GnRH analog contraceptive efficacy.