Omar Hatim A, Zakharia Rana M, Kanungo Shibani, Huff Marlene, McClanahan Kimberly
Department of Pediatrics, University of Kentucky, Lexington, USA.
ScientificWorldJournal. 2006 May 5;6:538-41. doi: 10.1100/tsw.2006.106.
Galactorrhea is rarely mentioned as a possible side effect of the use of Depot-Medroxyprogesterone Acetate (DMPA). Over the last few years, we have noticed an increased number of patients complaining of galactorrhea. A review of clinical data showed that between 1999 and 2005, 360 adolescents in our clinic used DMPA for at least 6 months. After medical follow-up, 13 (3.6%) of these patients were found to have developed galactorrhea. The mean age of the patients was 19.4 years with a range from 13-24. Prolactin levels in these patients were normal, and in all subjects, the galactorrhea resolved spontaneously within the next year in both patients who continued use and those who discontinued use of DMPA. It appears that galactorrhea is a benign side effect and as previous reports have suggested, it did not seem to be related to changes in Prolactin levels in our patients. It is thought that this is a progesterone-mediated effect. We believe that reassurance and education of patients is sufficient and there is no evidence of need for further intervention. Since the sample size is small in this study, additional research is recommended as to validate the presence of progesterone-mediated effects secondary to the use of DMPA.
泌乳很少被提及为使用醋酸甲羟孕酮长效注射剂(DMPA)可能产生的副作用。在过去几年中,我们注意到抱怨泌乳的患者数量有所增加。对临床数据的回顾显示,1999年至2005年期间,我们诊所的360名青少年使用DMPA至少6个月。经过医学随访,发现其中13名(3.6%)患者出现了泌乳。患者的平均年龄为19.4岁,范围在13至24岁之间。这些患者的催乳素水平正常,并且在所有受试者中,无论是继续使用还是停止使用DMPA的患者,泌乳在次年都自行消退。看来泌乳是一种良性副作用,正如先前的报告所表明的,它似乎与我们患者的催乳素水平变化无关。据认为,这是一种孕激素介导的效应。我们认为对患者进行安慰和教育就足够了,没有证据表明需要进一步干预。由于本研究的样本量较小,建议进行更多研究以验证使用DMPA后孕激素介导效应的存在。