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Cochrane Database of Systematic Reviews

Treatment of vaginal bleeding irregularities induced by progestin only contraceptives

Overview of attention for article published in Cochrane database of systematic reviews, October 2013
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About this Attention Score

  • Good Attention Score compared to outputs of the same age (67th percentile)

Mentioned by

1 policy source


27 Dimensions

Readers on

94 Mendeley
Treatment of vaginal bleeding irregularities induced by progestin only contraceptives
Published in
Cochrane database of systematic reviews, October 2013
DOI 10.1002/14651858.cd003449.pub5
Pubmed ID

Abdel-Aleem, Hany, d'Arcangues, Catherine, Vogelsong, Kirsten M, Gaffield, Mary Lyn, Gülmezoglu, A Metin, Hany Abdel‐Aleem, Catherine d'Arcangues, Kirsten M Vogelsong, Mary Lyn Gaffield, A Metin Gülmezoglu


Despite their high effectiveness, progestin-only contraceptives are considered less than ideal by the many women who experience irregular vaginal bleeding when using them. Current treatments to control these bleeding problems are not sufficiently effective. We evaluated preventive and therapeutic approaches to normalise bleeding irregularities associated with the use of progestin-only contraceptives. Literature was identified through database searches, reference lists, organisations and individuals, covering the period until May-June 2012. Trials with random or systematic allocation, testing interventions for the prevention or treatment of bleeding irregularities associated with the use of progestin-only contraceptives were eligible. Results are expressed as relative risks (RR) with 95% confidence interval (CI) for categorical data and as weighted mean difference (WMD) with 95% CI for continuous data. When we encountered heterogeneity (visual or statistical) we used the random-effects model (quantitative) or did not produce a summary estimate (qualitative). Thirty-three randomised controlled trials enrolling 3677 participants were included. Two thirds of the trials were determined to reflect low to moderate risk of bias.Estrogen treatments reduced the number of days of an ongoing bleeding episode in DMPA and Norplant users. However, treatment frequently led to more discontinuation due to gastrointestinal upset.Combinations of oral ethinyl estradiol and levonorgestrel improved bleeding patterns in Norplant users, but method discontinuation rates were unchanged. One trial reported successful use of combined oral contraceptives in treating amenorrhea among DMPA users.Norplant users, but not Implanon users, administered the anti-progestin mifepristone reported fewer days of bleeding during treatment than those given placebo. Mifepristone used monthly by new Norplant acceptors reduced bleeding, when compared to placebo.A variety of NSAIDS have been evaluated for their ability to treat abnormal bleeding, with mixed results.Norplant users receiving SERM (tamoxifen) had less unacceptable bleeding after treatment and were more likely to continue using Norplant than those receiving placebo.Tranexamic acid, mifepristone combined with an estrogen and doxycycline were more effective than placebo in terminating an episode of bleeding in women using progestin-only contraceptives, according to three small studies. Some women may benefit from the interventions described, particularly with cessation of current bleeding. Several regimens offer promise in regulating bleeding, but findings need to be reproduced in larger trials. The results of this review do not support routine clinical use of any of the regimens included in the trials, particularly for long-term effect.

Mendeley readers

The data shown below were compiled from readership statistics for 94 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 94 100%

Demographic breakdown

Readers by professional status Count As %
Student > Postgraduate 12 13%
Researcher 12 13%
Student > Bachelor 12 13%
Student > Master 10 11%
Student > Ph. D. Student 7 7%
Other 18 19%
Unknown 23 24%
Readers by discipline Count As %
Medicine and Dentistry 44 47%
Nursing and Health Professions 10 11%
Social Sciences 3 3%
Pharmacology, Toxicology and Pharmaceutical Science 3 3%
Biochemistry, Genetics and Molecular Biology 2 2%
Other 7 7%
Unknown 25 27%

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 January 2014.
All research outputs
of 12,101,174 outputs
Outputs from Cochrane database of systematic reviews
of 7,978 outputs
Outputs of similar age
of 211,099 outputs
Outputs of similar age from Cochrane database of systematic reviews
of 197 outputs
Altmetric has tracked 12,101,174 research outputs across all sources so far. This one is in the 49th percentile – i.e., 49% of other outputs scored the same or lower than it.
So far Altmetric has tracked 7,978 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.6. This one is in the 30th percentile – i.e., 30% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 211,099 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 67% of its contemporaries.
We're also able to compare this research output to 197 others from the same source and published within six weeks on either side of this one. This one is in the 20th percentile – i.e., 20% of its contemporaries scored the same or lower than it.