Magnitude and variability of sequential estradiol and progesterone concentrations in women using depot medroxyprogesterone acetate for contraception

Objective: To describe the magnitude and variability of sequential serum es tradiol and progesterone concentrations throughout one depot medroxyprogest erone (DMPA) injection interval. Design: Prospective study. Setting: Family planning and women's health clinics. Patient(s): Thirty-one women, ages 19 to 46, using DMPA for contraception. Intervention(s): Serum for estrogen and progesterone was collected weekly t hroughout one DMPA injection interval. Main Outcome Measure(s): Serum estradiol and progesterone concentrations: e stradiol patterns produced from data plotted across the entire DMPA injecti on interval. Result(s): The average daily estradiol concentrations ranged from 7.9 to 69 .1 pg/mL, with a mean of 18.9 +/- 12.9 and a median of 15.4 pg/mL. Average daily progesterone concentrations ranged from 0.14 to 1.1 ng/mL, with a mea n of 0.40 +/- 0.19 ng/mL and a median of 0.36 ng/mL. Two general patterns o f estradiol concentrations were identified. One pattern. observed in approx imately one third of the participants, reflected estradiol concentrations t hat were extremely low (mean, 12.7 +/- 3.6 pg/mL; median, 13.3 pg/mL) and c onsistently hat across the DMPA injection interval. The second pattern. see n in the remaining participants, reflected estradiol concentrations that we re higher (mean, 22.2 +/- 14.9 pg/mL, median, 17.3 pg/mL) and quits variabl e. Conclusion(s): This study demonstrated that estradiol concentrations were l ower than the 40 to 50 pg/mL reported in most studies and, for the majority of women, varied substantially across the DMPA injection interval. (Fertil Steril(R) 2001;75:871-7. (C)2001 by American Society for Reproductive Medi cine.).