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4 progestational contraceptive formulations were tested for their effects and effectiveness as contraceptives during postpartum lactation. 100 women were enrolled in the study and were divided into 4 groups: Group 1 monthly injections of 300 mg of Depo-Provera intramuscularly; Group 2 monthly intramuscular injections of 150 mg of Deladroxone (dihydroxyprogesterone acetophenide); Group 3 daily per oral administration of .5 mg of chlormadinone acetate; and Group 4 daily per oral administration of quingestanol acetate. Milk samples were collected on the 3rd 5th and 7th days and then monthly until the end of the 12th month for biochemical assays. Initiation of lactation was not affected by using any of the 4 progestogens. Milk yield was lowest in Group 3 but was basically comparable in all groups. Lipid content of milk showed no significant difference among groups receiving medication and between medicated groups and controls during the 1st month. Later drops were demonstrated. Lactose content showed a rise during the 3rd and 5th days postpartum in all groups as compared to controls and later it dropped. Body weights of infants in medicated groups and controls fell within established percentiles; however male and female infants of Groups 1 and 3 showed the greatest increment increase. No pregnancies occurred. Menstrual patterns are shown figuratively. Menstrual disturbances were however the main complaint and side effect of this postpartum contraception. Abdominal distension occurred in 12% of the Depo-Provera users and in 4% of the chlormadinone acetate group. 2% of Deladroxone users reported loss of hair. Depo-Provera showed the best results followed by Deladroxone quingestanol acetate and chlormadinone acetate.

The effect of monthly injectios of 300 mg Depo-Provera or 150 mg Deladroxone and of daily oral administration of .5 mg chlormadinone acetate or .3 mg quingestanol acetate on lactation was studied in Egyptian women during the 1st year of lactation. Women receiving Depo-Provera had the highest milk yield followed by those taking Deladroxone and quingestanol acetate. The milk yields while taking these hormonal preparations were higher than in untreated controls. However those women taking chlormadinone acetate had lower milk yields than untreated controls. The increased milk yield is probably due to the progestagenic activity and minimal estrogenicity of these drugs.

The effects of progestational steroids on the chemical composition of milk during the 1st year of lactation are described. The milk samples were analyzed for total protein lipid and lactose content. When compared with a group of nonmedicated women chlormadinone acetate Depo-Provera and Deladroxone all caused a marked increase in protein co ntent in the early stages of lactation while quingestanol acetate had little overall effect. The average protein content in gm% over the period was as follows: chlormadinone acetate 1.07 Depo-Provera 1.04 Deladroxone .96 quingestanol acetate .86 and controls .83. Lipid and lactose content showed irregular changes in the medicated groups as compared with the controls. The general trend towards an increase in milk protein with all 4 progestagens may be explained by the direct stimulating effect of their estrogenic metabolites on mammary tissue.