Priority 17 from the Contraception PSP

UNCERTAINTY: Are there factors (ethnicity, past experience) that can predict who is at risk of irregular bleeding when using hormonal contraception (progestogen only or combined)?  (JLA PSP Priority 17)
Overall ranking 17
JLA question ID 0049/17
Explanatory note The systematic reviews evaluate the risk of side effects with CHC and treatment for irregular bleeding with progestogen only methods. The interventions themselves maybe a factor in the risk of bleeding but the questions is about the patient factors which may influence this, which is not directly addressed by either review. 

Types of progestogens in combined oral contraception: effectiveness and side-effects.Theresa A Lawrie , Frans M Helmerhorst , Nandita K. Maitra , Regina Kulier , Kitty Bloemenkamp and A Metin Gülmezoglu. May 2011

Treatment of vaginal bleeding irregularities induced by progestin only contraceptivesHany Abdel‐Aleem, Catherine d'Arcangues, Kirsten M Vogelsong, Mary Lyn Gaffield, A Metin Gülmezoglu. October 2013 

Health Research Classification System category Reproductive Health and Childbirth
Extra information provided by this PSP
Original uncertainty examples

“I don't tolerate progesterone only contraception e.g. mini pill, injection, implant - what is it in these that causes me to constantly bleed?” (patient)  ~  “Is there a way to predict bleeding patterns for particular women or to extrapolate from previously-used contraception?” (HCP) 

Submitted by Healthcare Professionals x 4~Patients x 1~Both x 0
PSP information
PSP unique ID 0049
PSP name Contraception
Total number of uncertainties identified by this PSP. 57  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 21 April 2017