Abstract

Progestins have shown to be highly effective, adequately safe contraceptives and a real alternative in the cases with contraindications to estrogen use. This review assesses the effectiveness of treatments for managing uterine bleeding due to the use of progestin-only contraceptives. A systematic review of databases such as Embase, LILACS, CINAHL, and PubMed, with a result of 701 studies published in English between 2005 and 2022, was carried out. 21 randomized clinical trials were analyzed. There were effective non-hormonal alternatives for managing progestin-related bleeding. While several treatments show promise, results must be replicated by studies with longer follow-up periods. Differences came from the five new studies and their good methodological quality-specifically, blinding and assessment of population losses. Benefits were the stop of uterine bleeding and a shortened duration of these episodes, with studies generally reporting satisfaction among their patients. There were few adverse effects seen, with the most common being headaches and nausea, which should be addressed by future studies. These results are expected to be of use for health professionals and midwives working on contraceptive management.