Effective Care Research Unit, Eastern Cape Department of Health/Universities of the Witwatersrand and Fort Hare, East London, South Africa.
FHI 360, Durham, NC, USA.
Int J Gynaecol Obstet. 2021 Aug;154(2):256-262. doi: 10.1002/ijgo.13594. Epub 2021 Mar 2.
To compare the effects of depot medroxyprogesterone acetate (DMPA-IM), levonorgestrel (LNG) implant, and copper intrauterine device (IUD) on mood and sexual function.
At the Effective Care Research Unit in South Africa, women already randomized in the ECHO Trial to the three methods were asked to participate in this study. Participants were interviewed at 3 and 12 months after enrollment using the Beck Depression Inventory and Arizona Sexual Experiences Scale, and at 12 months using the WHO-5 Wellbeing Index and the Patient Global Impression scale.
A total of 605 women participated. There was little difference in depression at 3 months across the three study groups. Contrary to our hypothesis, at 12 months, depression was lowest among DMPA-IM users (16/167, 9.6%) and highest among IUD users (28/158, 17.7%) (p = 0.032). There was little difference in sexual function at any time-point. More women in the DMPA-IM group felt "very much better" on the PGI scale than in the IUD and LNG implant groups (p = 0.003).
Depression may be less likely with DMPA-IM than with the other methods 1 year after initiation. Major differences in sexual functioning are unlikely. Unhappiness related to not using DMPA-IM, the most popular method in our setting, may have skewed results.
PACTR201706001651380.
比较长效醋酸甲羟孕酮（DMPA-IM）、左炔诺孕酮（LNG）埋植剂和铜宫内节育器（IUD）对情绪和性功能的影响。
在南非有效护理研究单位，已经按 ECHO 试验随机分配到这三种方法的女性被要求参与这项研究。参与者在入组后 3 个月和 12 个月使用贝克抑郁量表和亚利桑那性体验量表，在 12 个月时使用 WHO-5 健康指数和患者总体印象量表进行访谈。
共有 605 名女性参与。在三个研究组中，3 个月时的抑郁程度差异不大。与我们的假设相反，在 12 个月时，DMPA-IM 使用者的抑郁程度最低（16/167，9.6%），IUD 使用者的抑郁程度最高（28/158，17.7%）（p=0.032）。在任何时间点，性功能差异都不大。在 PGI 量表上，DMPA-IM 组中有更多的女性感觉“好得多”（p=0.003）。
与其他方法相比，在开始使用 DMPA-IM 1 年后，发生抑郁的可能性更小。性功能方面的主要差异不太可能出现。与未使用 DMPA-IM（在我们的环境中最受欢迎的方法）相关的不快乐可能会使结果产生偏差。
PACTR201706001651380。
