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Andrew M. Kaunitz - One of the best experts on this subject based on the ideXlab platform.

  • use of Depot Medroxyprogesterone Acetate contraception and incidence of bone fracture
    Obstetrics & Gynecology, 2013
    Co-Authors: Lee L Lanza, Andrew M. Kaunitz, Zeev Harel, Lisa J Mcquay, Kenneth J Rothman, Henry G Bone, Quazi Ataher, Douglas Ross, Philip L Arena, Kevin Wolter
    Abstract:

    OBJECTIVE:: Depot Medroxyprogesterone Acetate (DMPA) reversibly reduces bone mineral density. To estimate the extent to which DMPA might increase fracture risk we undertook a retrospective cohort study of fractures in DMPA users and users of non-DMPA contraceptives using the General Practice Research Database. METHODS:: Eligible women were aged younger than 50 years at the qualifying first contraceptive prescription. The DMPA users were classified by DMPA exposure (cumulative and time of last dose) based on prescription records. All incident fractures were included; fracture incidence and risk factors before starting contraceptive use (DMPA or other) also were estimated. RESULTS:: We identified 11822 fractures in 312395 women during 1722356 person-years of follow-up. Before contraceptive use started DMPA users had higher fracture risk than nonusers (incidence rate ratio 1.28 95% confidence interval [CI] 1.07-1.53). After DMPA started crude fracture incidence was 9.1 per 1000 person-years for DMPA users and 7.3 for nonusers (crude incidence rate ratio 1.23 95% CI 1.16-1.30). Fracture risk in DMPA users did not increase after starting DMPA (incidence rate ratio after or before 1.08 95% CI 0.92-1.26). There was little confounding by age or other factors that could be measured. Fracture incidence was 9.4 per 1000 person-years in low-exposure DMPA users and 7.8 per 1000 in high-exposure DMPA users. The DMPA users had higher fracture risk than nonusers at the start of contraceptive use with no discernible induction period. CONCLUSION:: Although DMPA users experienced more fractures than nonusers this association may be the result of confounding by a pre-existing higher risk for fractures in women who chose DMPA for contraception. LEVEL OF EVIDENCE:: II.

  • bone density recovery after Depot Medroxyprogesterone Acetate injectable contraception use
    Contraception, 2008
    Co-Authors: Andrew M. Kaunitz, Raquel D Arias, Michael Mcclung
    Abstract:

    While Depot Medroxyprogesterone Acetate (DMPA) is a highly effective contraceptive used by millions of women, its use is associated with bone mineral density (BMD) loss, raising concerns about long-term risk of osteoporosis and/or fractures.

  • bone mineral density in women aged 25 35 years receiving Depot Medroxyprogesterone Acetate recovery following discontinuation
    Contraception, 2006
    Co-Authors: Andrew M. Kaunitz, Doug Ross, Paul D Miller, Valerie Montgomery Rice, Michael R Mcclung
    Abstract:

    Abstract Introduction This 7-year, prospective, matched-cohort, clinical study evaluated the effects of intramuscular Depot Medroxyprogesterone Acetate (DMPA) (150 mg/mL) on bone mineral density (BMD) in women aged 25���35 years. Methods Bone mineral density changes in new DMPA-IM users ( n =248) were compared with those in women using nonhormonal contraception ( n =360) for up to 240 weeks of treatment and 96 weeks of posttreatment follow-up (in subjects receiving ���1 dose). Results At week 240 of treatment, mean percentage changes from baseline in DMPA-IM vs. nonhormonal subjects were: ���5.16% ( n =21) vs. +0.19% ( n =65), total hip (p n =33) vs. +0.43% ( n =105), lumbar spine (p n =25) vs. +0.84% ( n =43), total hip (p=.047); ���1.19% ( n =41) vs. +0.47% ( n =66), lumbar spine (p=.017). Conclusions These results show BMD declines during DMPA-IM use; following discontinuation, significant increases in BMD occur through 96 weeks posttreatment.

  • Depot Medroxyprogesterone Acetate and bone mineral density in adolescents the black box warning a position paper of the society for adolescent medicine
    Journal of Adolescent Health, 2006
    Co-Authors: Barbara A Cromer, Delia Scholes, Abbey B. Berenson, Tim Cundy, Kathleen M Clark, Andrew M. Kaunitz
    Abstract:

    The purpose of this Position Paper is to review the published Black Box Warning regarding Depot Medroxyprogesterone Acetate (DMPA) and bone loss as it relates to adolescent girls. The scientific findings that prompted the Food and Drug Administration to issue the warning are reviewed and the following additional issues are considered: (1) likely low risk of fracture related to DMPA use, (2) evidence of at least partial recovery after discontinuation of the method, and (3) the need to balance the physical, social and economic cost of adolescent pregnancy versus the immediate and long-term impact of DMPA on bone. A list of clinical guidelines is included, the main recommendation of which is to continue prescription of DMPA, with counseling about the risks and benefits, in most of the adolescent population desiring to use this contraceptive method.

  • long term use of contraceptive Depot Medroxyprogesterone Acetate in young women impairs arterial endothelial function assessed by cardiovascular magnetic resonance
    Circulation, 2002
    Co-Authors: Andrew M. Kaunitz
    Abstract:

    Background— Depot Medroxyprogesterone Acetate (DMPA) inhibits proliferation of ovarian follicles, resulting in anovulation and a decrease in circulating estrogen; the latter action is potentially disadvantageous to cardiovascular health. We therefore investigated the vascular effects of long-term contraceptive DMPA in young women. Methods and Results— Endothelium-dependent (hyperemia-induced flow-mediated dilatation [FMD]) and -independent (glyceryl trinitrate [GTN]) changes in brachial artery area were measured using cardiovascular magnetic resonance in 13 amenorrheic DMPA users (>1 year use; mean age 29±4 years) and in 10 controls (mean age 30±4 years, P=0.25) with regular menstrual cycles after validation of the technique. FMD and GTN responses were measured just before repeat MPA injection and 48 hours later (n=12) in DMPA users and during menstruation and midcycle (n=9) in controls. Serum-estradiol levels (S-estradiol) were measured at both visits. FMD was reduced in DMPA users compared with controls...

Luis Bahamondes - One of the best experts on this subject based on the ideXlab platform.

  • prevalence of low bone mass and osteoporosis in long term users of the injectable contraceptive Depot Medroxyprogesterone Acetate
    Journal of Womens Health, 2015
    Co-Authors: Waleska Modesto, Valeria M Bahamondes, Luis Bahamondes
    Abstract:

    Abstract Background: Bone mineral density (BMD) loss among Depot Medroxyprogesterone Acetate (DMPA) users is a controversial issue. Aspects under debate include whether the number of years of use has any effect on continuous BMD loss, whether this loss will stabilise over the years of use or if it will progress to low bone mass, osteoporosis and an increased fracture risk. The aim of this study was to compare the difference in osteoporosis and low bone mass between DMPA and copper intrauterine device (Cu-IUD) users. Methods: This was a cross-sectional study that evaluated BMD at the lumbar spine and femoral neck in 47 long-term DMPA users and 41 Cu-IUD users as control group. BMD was measured by dual-energy X-ray absorptiometry. The participants were 27 to 57 years of age, had used either DMPA or a Cu-IUD uninterruptedly for at least ten years, had initiated use of the method prior to 40 years of age and had follicle stimulating hormone values <40 mIU/mL. Results: Findings showed that 68.1% and 36.6% of t...

  • variations in body mass index of users of Depot Medroxyprogesterone Acetate as a contraceptive
    Contraception, 2010
    Co-Authors: Marcia Pantoja, Luis Bahamondes, Tatiane Medeiros, Maria Carolina Baccarin, Sirlei Siani Morais, Arlete Fernandes
    Abstract:

    Abstract Background Weight gain is a frequent reason for discontinuing the contraceptive with Depot-Medroxyprogesterone Acetate (DMPA). Study Design This 3-year retrospective cohort study assessed body mass index (BMI; kg/m 2 ) variations in 379 current or past DMPA users compared to TCu380A intrauterine device (IUD) users matched for age and BMI, categorized into G1 (normal weight), G2 (overweight) or G3 (obese) according to baseline BMI. Variations in weight and BMI were evaluated using analysis of variance. Results BMI increased progressively in all groups but significantly more in G1 and G2 DMPA users compared to nonusers and according to duration of use. In the G3 subgroup, weight trends were similar in the DMPA and IUD users. Conclusions Normal and overweight women increased BMI with DMPA use; however, obese women did not increase weight. Weight increase in DMPA users could be associated with metabolic alterations related to duration of use in normal and overweight women and to alterations already present in obese women. Prospective studies are required to determine triggering factors. DMPA use ���3 years was not associated with weight increase in women with BMI (kg/m 2 ) ���30.

  • pharmacokinetic interactions between Depot Medroxyprogesterone Acetate and combination antiretroviral therapy
    Fertility and Sterility, 2008
    Co-Authors: Kavita Nanda, Eliana Amaral, Melissa Hays, Marco Aurelio Martino Viscola, Neha Mehta, Luis Bahamondes
    Abstract:

    Objective To evaluate the effect of an antiretroviral (ARV) therapy regimen containing zidovudine (AZT), lamivudine (3TC), and efavirenz (EFV) on the pharmacokinetics of Depot Medroxyprogesterone Acetate (DMPA). Design Open-label, nonrandomized, clinical trial. Setting University hospital clinic. Patient(s) Thirty HIV-infected women; 15 using ARV therapy (AZT, 3TC, and EFV) and 15 non-users of ARV therapy, followed biweekly for 12 weeks. Intervention(s) Single injection of DMPA (150 mg IM) for both groups. Main Outcome Measure(s) Pharmacokinetic parameters of DMPA by liquid chromatography with mass spectrometry, and ovulation by serum P. Result(s) Maximum serum concentrations of DMPA were reached at 14 days after injection. The area under the curve was similar in both groups, as were the minimum concentration, half-life, and clearance. Only 1 woman, not using ARV therapy, ovulated at 11 weeks after DMPA. Conclusion(s) Pharmacokinetics of DMPA were similar in HIV-infected women, regardless of ARV therapy use, suggesting that triple therapy with AZT, 3TC, and EFV is not likely to interfere with the contraceptive effectiveness of DMPA.

  • randomized assignment to copper iud or Depot Medroxyprogesterone Acetate feasibility of enrollment continuation and disease ascertainment
    Contraception, 2005
    Co-Authors: Paul J Feldblum, Luis Bahamondes, Jennifer Caraway, Mohamed K Elshafei, Edwin Morales, Silver Wevill, Sean Condon
    Abstract:

    Abstract Objectives We conducted a feasibility study to enroll and follow family planning acceptors who were randomly assigned to use an intrauterine device (IUD) or injectable Depot-Medroxyprogesterone Acetate (DMPA). Methods Centers in Brazil, Guatemala, Egypt and Vietnam aimed to enroll 100 participants per site. Enrolled women were randomly assigned to have inserted a TCu 380A IUD, or to receive injections of 150 mg of DMPA every 3 months, and scheduled for up to 12 months of follow-up. We tested for cervical infection at first and final visits, and examined for signs of pelvic inflammatory disease (PID) at each visit. Results The sites screened 555 women and enrolled 368. Two women (0.5%) had three discomfort signs of PID during follow-up. The prevalence of gonorrhea at each woman's final follow-up visit was 0.5%, and the prevalence of chlamydia at final visit was 5.4%. Sixty-eight percent of women either completed 12 months of observation with their assigned method or were still using their method at the end of the study. Conclusion A larger, definitive clinical trial appears feasible. The majority of women we approached agreed to participate; nearly 400 women were enrolled; two thirds continued to use their assigned method until study closeout; and the STI risk was moderate.

  • comparison of weight increase in users of Depot Medroxyprogesterone Acetate and copper iud up to 5 years
    Contraception, 2001
    Co-Authors: Luis Bahamondes, Soledad Del Castillo, Gonzalo Tabares, Ximena Espejo Arce, Marcos Perrotti, Carlos Alberto Petta
    Abstract:

    Abstract The objective of this study was to evaluate retrospectively the weight variation in long-term users of Depot Medroxyprogesterone Acetate (DMPA) compared to users of the TCu380A intrauterine device (IUD). A cohort of 206 healthy women allocated in two groups of 103 women according to the contraceptive method used was evaluated through 5 years. Each user of DMPA was paired with an IUD user by age (± 1 year) and weight (± 1 kg) at the beginning of the study. Weight was evaluated yearly during 5 years. The mean age at the beginning of the study was 33.1 years in both groups, and the mean weight was 59.4 kg in the IUD users and 60.4 kg in the DMPA group. Both cohorts of women presented significant weight increase at the end of the 5 years of observation (p

Amrit Ray - One of the best experts on this subject based on the ideXlab platform.

  • changes in weight with Depot Medroxyprogesterone Acetate subcutaneous injection 104 mg 0 65 ml
    Contraception, 2007
    Co-Authors: Carolyn Westhoff, John K Jain, Ian Milsom, Amrit Ray
    Abstract:

    Abstract Introduction The study was conducted to assess the impact of Depot Medroxyprogesterone Acetate subcutaneous injection 104 mg/0.65 mL (DMPA-SC 104) on body weight. Methods Changes in weight from pretreatment were analyzed using data from two 1-year, noncomparative trials of DMPA-SC 104 (North/South American, N =722; European/Asian, N =1065) and a 3-year, randomized study (SC/IM) comparing DMPA-SC 104 ( N =266) with the DMPA intramuscular injection 150 mg/mL (DMPA-IM 150). For each study, additional analyses were conducted for changes in body weight by age ( 35 years) and body mass index (BMI) (���25, >25 to ���30 and >30 kg/m 2 ) subgroups. Results In both 1-year trials, the mean (��SD) weight gain at month 12 was Conclusion DMPA-SC 104 was associated with modest weight gain in most women.

  • changes in bleeding patterns with Depot Medroxyprogesterone Acetate subcutaneous injection 104 mg
    Contraception, 2006
    Co-Authors: Raquel D Arias, Doug Ross, John K Jain, Cosima Brucker, Amrit Ray
    Abstract:

    Abstract Objective This study aims to assess changes in bleeding patterns with the use of Depot Medroxyprogesterone Acetate (DMPA) 104 mg/0.65 ml subcutaneous injection (DMPA-SC 104). Study Design An analysis was conducted using data from two 1-year, noncomparative clinical trials (N=1787) and a 2-year randomized study comparing DMPA-SC 104 (N=266) with DMPA intramuscular injection (DMPA-IM). Bleeding was analyzed per 30-day interval by category and number of days. Analyses also were performed for age and body mass index (BMI) subgroups and for the percentages of women shifting from bleeding/spotting to amenorrhea after each injection. Results Each study showed decreased incidence of irregular bleeding and increased amenorrhea with continued use of DMPA-SC 104. Rates of amenorrhea at Month 12 (52–64% across studies) and Month 24 (71% in the 2-year trial) were comparable with those originally reported for DMPA-IM. Changes in bleeding patterns showed no consistent differences according to age or BMI. The percentages of subjects shifting from bleeding and/or spotting to amenorrhea increased with each subsequent injection. Conclusion Clinical data show that the incidence of amenorrhea increases over time with the use of DMPA-SC 104.

  • subcutaneous Depot Medroxyprogesterone Acetate versus leuprolide Acetate in the treatment of endometriosis associated pain
    Human Reproduction, 2006
    Co-Authors: Pier Giorgio Crosignani, Anthony A. Luciano, Amrit Ray, Agneta Bergqvist
    Abstract:

    BACKGROUND A clinical study compared efficacy and safety of Depot Medroxyprogesterone Acetate (DMPA) with leuprolide for endometriosis-associated pain. METHODS This multicentre, 18 month, evaluator-blinded, comparator-controlled trial randomized 300 women with laparoscopically diagnosed endometriosis to 6 month treatment with subcutaneous injection of 104 mg/0.65 ml DMPA (DMPA-SC 104) every 3 months or leuprolide (3.75 mg monthly or 11.25 mg every 3 months), with 12 months post-treatment follow-up. Endpoints included patient response to treatment in five signs/symptoms (dysmenorrhoea, dyspareunia, pelvic pain, pelvic tenderness, induration) and changes in bone mineral density (BMD) and productivity at 6 and 18 months. RESULTS DMPA-SC 104 and leuprolide produced equivalent (P < 0.02) reductions in at least four pain categories and significant (P < 0.001) improvements in composite score at months 6 and 18. At month 6, reductions in total hip and lumbar spine BMD were significantly less (P < 0.001) with DMPA-SC 104 versus leuprolide. BMD returned to pre-treatment levels 12 months post-treatment in the DMPA-SC 104 but not the leuprolide group. Total productivity also significantly (P < or = 0.05) improved in both groups at 6 and 18 months. CONCLUSIONS DMPA-SC 104 reduces endometriosis-associated pain as effectively as leuprolide and improves productivity with significantly less BMD decline.

Barbara A Cromer - One of the best experts on this subject based on the ideXlab platform.

  • recovery of bone mineral density in adolescents following the use of Depot Medroxyprogesterone Acetate contraceptive injections
    Contraception, 2010
    Co-Authors: Zeev Harel, Barbara A Cromer, Christine Cole Johnson, Melanie A Gold, Edward L Peterson, Ronald T Burkman, Margaret Stager, Robert H Brown, Ann Bruner, Susan M Coupey
    Abstract:

    Abstract Background Depot Medroxyprogesterone Acetate (DMPA) is a highly effective progestin-only contraceptive that is widely used by adolescents. We investigated bone mineral density (BMD) changes in female adolescents during and following use of this method. Study Design A multicenter, prospective, non-randomized observational study in 98 healthy female adolescents aged 12–18 years who initiated DMPA intramuscular injections for contraception and provided BMD data for up to 240 weeks while receiving DMPA and for up to 300 weeks after DMPA cessation. BMD at the lumbar spine (LS), total hip (TH) and femoral neck (FN) was assessed by dual-energy X-ray absorptiometry. A mixed model analysis of variance was used to examine BMD changes. Results At the time of their final DMPA injection, participants had mean BMD declines from baseline of 2.7% (LS), 4.1% (TH) and 3.9% (FN) (p Conclusions BMD loss in female adolescents receiving DMPA for contraception is substantially or fully reversible in most girls following discontinuation of DMPA, with faster recovery at the LS than at the hip.

  • Depot Medroxyprogesterone Acetate and bone mineral density in adolescents the black box warning a position paper of the society for adolescent medicine
    Journal of Adolescent Health, 2006
    Co-Authors: Barbara A Cromer, Delia Scholes, Abbey B. Berenson, Tim Cundy, Kathleen M Clark, Andrew M. Kaunitz
    Abstract:

    The purpose of this Position Paper is to review the published Black Box Warning regarding Depot Medroxyprogesterone Acetate (DMPA) and bone loss as it relates to adolescent girls. The scientific findings that prompted the Food and Drug Administration to issue the warning are reviewed and the following additional issues are considered: (1) likely low risk of fracture related to DMPA use, (2) evidence of at least partial recovery after discontinuation of the method, and (3) the need to balance the physical, social and economic cost of adolescent pregnancy versus the immediate and long-term impact of DMPA on bone. A list of clinical guidelines is included, the main recommendation of which is to continue prescription of DMPA, with counseling about the risks and benefits, in most of the adolescent population desiring to use this contraceptive method.

  • Depot Medroxyprogesterone Acetate oral contraceptives and bone mineral density in a cohort of adolescent girls
    Journal of Adolescent Health, 2004
    Co-Authors: Barbara A Cromer, Margaret Stager, Andrea Bonny, Rina Lazebnik, Ellen S Rome, Julie Ziegler, Sara M Debanne
    Abstract:

    Purpose To conduct a longitudinal comparison of bone mineral density (BMD) in 370 adolescent girls, aged 12–18, who self-selected Depot Medroxyprogesterone Acetate (DMPA) or an oral contraceptive (OC) containing 20μg ethinyl estradiol/100μg levonorgestrel with that in girls who received no hormonal treatment (control group). Methods Lumbar spine and femoral neck BMD measurements were obtained by dual energy x-ray absorptiometry at baseline and 12 months. Data were analyzed with repeated measures analysis of covariance methods. Results Over 12 months, lumbar spine BMD decreased in the DMPA group (n = 29), with a mean percent change of −1.4% (95% confidence interval [CI] −2.73, −0.10), and increased by a mean of 3.8% (95% CI 3.11, 4.57) in the control group [n = 107 ( p p = .03). Over 12 months, the mean percent change in femoral neck BMD was −2.2% (95% CI −3.95, −0.39) in the DMPA group, but increased 2.3% (95% CI 1.29, 3.27) in the control group ( p p = .03). Conclusions Our study contributes to an increasing body of knowledge indicating a negative impact of DMPA on bone health in young women. Additional findings suggest a potential adverse effect of an OC containing 20 μg ethinyl estradiol/100 μg levonorgestrel on bone health in adolescents.

  • a prospective comparison of bone density in adolescent girls receiving Depot Medroxyprogesterone Acetate depo provera levonorgestrel norplant or oral contraceptives
    The Journal of Pediatrics, 1996
    Co-Authors: Barbara A Cromer, John D. Mahan, J M M Blair, Lara Zibners, Zoran Naumovski
    Abstract:

    Abstract OBJECTIVE: To examine bone density among adolescents receiving different forms of hormonal contraception along with that of control subjects. METHODS: Baseline and 1-year measures of lumbar vertebral bone density were obtained in girls receiving Depot Medroxyprogesterone Acetate (Depo-Provera) (n = 15), levonorgestrel (Norplant) (n = 7), or oral contraceptives (n = 9) and in girls receiving no hormonal treatment (n = 17). In a subsample of Depo-Provera users (n = 8), Norplant users (n = 3), and control subjects (n = 4), bone density measurements were repeated after 2 years. Bone density was measured by dual-energy x-ray absorptiometry. RESULTS: Body mass indexes, level of pubertal development, substance use, and reproductive histories were not significantly different among the groups. More black girls were represented in the initial Depo-Provera group ( p p p p p CONCLUSION: These data suggest that Depo-Provera may, at least temporarily, suppress the expected skeletal bone mineralization in adolescents, whereas Norplant and oral contraceptives are associated with the expected increase in bone density in this population. (J Pediatr 1996;129:671-6)

Widiasari Esti - One of the best experts on this subject based on the ideXlab platform.

  • HUBUNGAN ANTARA PENGGUNAAN INJEKSI Depot-Medroxyprogesterone Acetate (DMPA) DENGAN KADAR ESTRADIOL PADA PENDERITA KANKER PAYUDARA
    2017
    Co-Authors: Widiasari Esti
    Abstract:

    HUBUNGAN PENGGUNAAN INJEKSI Depot-Medroxyprogesterone Acetate (DMPA) DENGAN KADAR ESTRADIOL PADA PENDERITA KANKER PAYUDARA Esti Widiasari*, Widyanti Soewoto** *Bagian Bedah Fakultas Kedokteran Universitas Sebelas Maret/RSUD Dr. Moewardi Surakarta. **Subbagian Bedah Onkologi Fakultas Kedokteran Universitas Sebelas Maret/RSUD Dr. Moewardi Surakarta. Abstrak Latar Belakang :Depot-Medroxyprogesterone Acetate (DMPA) yaitu kontrasepsi parenteral yang mempunyai efek progesterone yang kuat dan efektif. Penggunaan selama 12 bulan atau lebih dapat mempengaruhi kadar estradiol yang dapat melipat gandakan risiko terkena kanker payudara. Tujuan :Menganalisis adanya hubungan penggunaan injeksi Depot-Medroxyprogesterone Acetate (DMPA) terhadap kadar estradiol pada penderita kanker payudara Metode :Rancangan penelitian ini adalah penelitian analitik observasional dengan pendekatan case control. Sampel dalam penelitian ini adalah 37 orang yang terdiri dari 18 orang dengan riwayat menggunakan injeksi Depot-Medroxyprogesterone Acetate (DMPA) sebagai kontrasepsi selama 12 bulan, yang dimasukkan ke kelompok I. Dan 19 orang yang tidak pernah menggunakan injeksi Depot-Medroxyprogesterone Acetate (DMPA) sebagai kontrasepsi, yang dimasukkan ke kelompok II. Teknik sampling yang digunakan pada penelitian ini adalah Consecutive Sampling. Subyek penelitian dibagi 2, kelompok I pasien Kanker Payudara dengan riwayat injeksi Depot-Medroxyprogesterone Acetate (DMPA) sebagai kontrasepsi lebih dari 12 bulan, dan kelompok II pasien Kanker Payudara tanpa riwayat injeksi Depot-Medroxyprogesterone Acetate (DMPA). Tiap kelompok diukur kadar estradiol dari sampel darah dan pemeriksaan dilakukan di laboratorium, dengan pemeriksaan ELISA estradiol. Data yang diperoleh diuji dengan uji mann whitney karena data tidak berdistribusi normal, uji beda dengan menggunakan SPSS 19.0. Hasil :Sebaran menurut umur pada pasien kanker payudara dengan riwayat menggunakan injeksi Depot-Medroxyprogesterone Acetate (DMPA) selama 12 bulan sebagai kontrasepsi , sebaran umur yang paling tinggi pada rentang umur 46-50 tahun (38,9%) dan sebaran umur paling rendah pada rentang umur 56-60 tahun (0%). Pada pasien kanker payudara tanpa riwayat injeksi Depot-Medroxyprogesterone Acetate (DMPA) sebagai kontrasepsi didapatkan hasil merata pada rentang umur 36-40 tahun (15,78%), rentang umur 41-45 tahun (15,78%), dan rentang umur 66-70 tahun (15,78%). Berdasarkan hasil pengukuran menggunakan Estradiol ELISA kit DRG® diketahui bahwa tidak ada peningkatan kadar estradiol baik pada Pasien Kanker Payudara dengan riwayat injeksi Depot-Medroxyprogesterone Acetate (DMPA) sebagai kontrasepsi selama 12 bulan, (kelompok I) dan Pasien Kanker Payudara tanpa riwayat injeksi Depot-Medroxyprogesterone Acetate (DMPA) sebagai kontrasepsi, (kelompok II). Hasil uji mann whitney pada penelitian ini menunjukkan p = 0,126 (p >0,05). Dengan demikian tidak adanya hubungan antara penggunaan injeksi Depot-Medroxyprogesterone Acetate (DMPA) dengan peningkatan kadar estradiol selama 12 bulan, yang dapat meningkatkan resiko terjadinya Kanker Payudara. Simpulan : Berdasarkan hasil penelitian yang dilakukan terhadap 37 Pasien kanker payudara sejak bulan maret 2016 sampai dengan mei 2016 di sub bagian bedah onkologi RS Dr. Moewardi Surakarta. Maka dapat disimpulkan bahwa penggunaan injeksi Depot-Medroxyprogesterone Acetate (DMPA) tidak berhubungan dengan peningkatan kadar estradiol. Kata kunci :Depot-Medroxyprogesterone Acetate (DMPA), Estradiol, Kontrasepsi, Kanker Payudara

  • hubungan antara penggunaan injeksi Depot-Medroxyprogesterone Acetate (DMPA) dengan kadar estradiol pada penderita kanker payudara
    2016
    Co-Authors: Widiasari Esti
    Abstract:

    Latar Belakang :Depot-Medroxyprogesterone Acetate (DMPA) yaitu kontrasepsi parenteral yang mempunyai efek progesterone yang kuat dan efektif. Penggunaan selama 12 bulan atau lebih dapat mempengaruhi kadar estradiol yang dapat melipat gandakan risiko terkena kanker payudara. Tujuan :Menganalisis adanya hubungan penggunaan injeksi Depot-Medroxyprogesterone Acetate (DMPA) terhadap kadar estradiol pada penderita kanker payudara Metode :Rancangan penelitian ini adalah penelitian analitik observasional dengan pendekatan case control. Sampel dalam penelitian ini adalah 37 orang yang terdiri dari 18 orang dengan riwayat menggunakan injeksi Depot-Medroxyprogesterone Acetate (DMPA) sebagai kontrasepsi selama 12 bulan, yang dimasukkan ke kelompok I. Dan 19 orang yang tidak pernah menggunakan injeksi Depot-Medroxyprogesterone Acetate (DMPA) sebagai kontrasepsi, yang dimasukkan ke kelompok II. Teknik sampling yang digunakan pada penelitian ini adalah Consecutive Sampling. Subyek penelitian dibagi 2, kelompok I pasien Kanker Payudara dengan riwayat injeksi Depot-Medroxyprogesterone Acetate (DMPA) sebagai kontrasepsi lebih dari 12 bulan, dan kelompok II pasien Kanker Payudara tanpa riwayat injeksi Depot-Medroxyprogesterone Acetate (DMPA). Tiap kelompok diukur kadar estradiol dari sampel darah dan pemeriksaan dilakukan di laboratorium, dengan pemeriksaan ELISA estradiol. Data yang diperoleh diuji dengan uji mann whitney karena data tidak berdistribusi normal, uji beda dengan menggunakan SPSS 19.0. Hasil :Sebaran menurut umur pada pasien kanker payudara dengan riwayat menggunakan injeksi Depot-Medroxyprogesterone Acetate (DMPA) selama 12 bulan sebagai kontrasepsi , sebaran umur yang paling tinggi pada rentang umur 46-50 tahun (38,9%) dan sebaran umur paling rendah pada rentang umur 56-60 tahun (0%). Pada pasien kanker payudara tanpa riwayat injeksi Depot-Medroxyprogesterone Acetate (DMPA) sebagai kontrasepsi didapatkan hasil merata pada rentang umur 36-40 tahun (15,78%), rentang umur 41-45 tahun (15,78%), dan rentang umur 66-70 tahun (15,78%). Berdasarkan hasil pengukuran menggunakan Estradiol ELISA kit DRG® diketahui bahwa tidak ada peningkatan kadar estradiol baik pada Pasien Kanker Payudara dengan riwayat injeksi Depot-Medroxyprogesterone Acetate (DMPA) sebagai kontrasepsi selama 12 bulan, (kelompok I) dan Pasien Kanker Payudara tanpa riwayat injeksi Depot-Medroxyprogesterone Acetate (DMPA) sebagai kontrasepsi, (kelompok II). Hasil uji mann whitney pada penelitian ini menunjukkan p = 0,126 (p >0,05). Dengan demikian tidak adanya hubungan antara penggunaan injeksi Depot-Medroxyprogesterone Acetate (DMPA) dengan peningkatan kadar estradiol selama 12 bulan, yang dapat meningkatkan resiko terjadinya Kanker Payudara. Simpulan : Berdasarkan hasil penelitian yang dilakukan terhadap 37 Pasien kanker payudara sejak bulan maret 2016 sampai dengan mei 2016 di sub bagian bedah onkologi RS Dr. Moewardi Surakarta. Maka dapat disimpulkan bahwa penggunaan injeksi Depot-Medroxyprogesterone Acetate (DMPA) tidak berhubungan dengan peningkatan kadar estradiol. Kata kunci :Depot-Medroxyprogesterone Acetate (DMPA), Estradiol, Kontrasepsi, Kanker Payudara