Contraceptive efficacy and safety of DMPA-SC

Jain, John K.; Jakimiuk, Artur; Bode, F. R.; Ross, Douglas S.; Kaunitz, Andrew M.

doi:10.1016/j.contraception.2004.06.011

Cited by 156 publications

(93 citation statements)

References 14 publications

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“…Both subcutaneous and intramuscular DMPA show similar delays to fertility after injection. 95 However, for adolescent patients, such a delay does not usually pose a major deterrent to using this method.…”

Section: Progestin Injectionsmentioning

confidence: 99%

Contraception for Adolescents

Ott

Sucato²

2014

Pediatrics

244

133

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A working knowledge of contraception will assist the pediatrician in both sexual health promotion as well as treatment of common adolescent gynecologic problems. Best practices in adolescent anticipatory guidance and screening include a sexual health history, screening for pregnancy and sexually transmitted infections, counseling, and if indicated, providing access to contraceptives. Pediatricians’ long-term relationships with adolescents and families allow them to help promote healthy sexual decision-making, including abstinence and contraceptive use. Additionally, medical indications for contraception, such as acne, dysmenorrhea, and heavy menstrual bleeding, are frequently uncovered during adolescent visits. This technical report provides an evidence base for the accompanying policy statement and addresses key aspects of adolescent contraceptive use, including the following: (1) sexual history taking, confidentiality, and counseling; (2) adolescent data on the use and side effects of newer contraceptive methods; (3) new data on older contraceptive methods; and (4) evidence supporting the use of contraceptives in adolescent patients with complex medical conditions.

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Section: Progestin Injectionsmentioning

confidence: 99%

Contraception for Adolescents

Ott

Sucato²

2014

Pediatrics

244

133

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“…Amenorrhoea rates of 55% at 12 months were found with subcutaneous DMPA compared with about 50% with the intramuscular formulation. 35 There have been no published studies so far of subjects using self-injection of subcutaneous DMPA. 36 Two combined products, both given monthly, have been developed by the World Health Organization (WHO).…”

Section: Injectable Contraceptionmentioning

confidence: 99%

New technologies in contraception

Rowlands

2008

BJOG

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New technologies in both reversible contraception and sterilisation are described. The review includes recent advances in the development of oral contraception, emergency contraception, injectable contraception, vaginal rings, subdermal implants, transdermal contraception, intrauterine devices, spermicides and barrier methods. It also covers methods of transcervical female sterilisation and more easily reversible male sterilisation.The emphasis is on the technology and its safety and effectiveness. Hormonal delivery systems are described in some detail. Mention is also made of research into vaccines and male hormonal methods, where progress has been disappointing.

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“…DMPA-SC was developed with the goals of (a) providing a formulation of DMPA which could be selfadministered at home, (b) minimizing side effects through dose reduction (104 mg DMPA-SC versus 150 mg DMPA-IM), (c) hastening the return to cyclic ovulation after DMPA discontinuation, and (d) maintaining contraceptive efficacy. While contraceptive efficacy is equivalent between the two formulations, studies among adult women demonstrate equivalent adverse event profiles [4], including time to ovulation after drug cessation [5]. Studies of adult women have demonstrated interest in and feasibility of self-administration of DMPA-SC [6], but this issue has not been addressed among younger women.…”

Section: Introductionmentioning

confidence: 99%

Self-administration of subcutaneous depot Medroxyprogesterone acetate by adolescent women

Williams

Hensel²,

Fortenberry³

2010

Contraception

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Background-Intramuscular depot medroxyprogesterone acetate (DMPA-IM) is now available in subcutaneous (SC) formulation, potentially allowing for home-based self-administration. We examined adolescents' interest in and proficiency at DMPA-SC self-administration.Study Design-This is a planned secondary analysis of a randomized controlled trial comparing pain between DMPA-IM and DMPA-SC. In the trial, study participants (N=55) aged 14-21 years were recruited at DMPA initiation and randomized to receive DMPA-IM or DMPA-SC. Participants received the alternate formulation at 3 months, chose formulation at 6 months, and could learn self-administration at 9 months. The current analysis is of the women who chose selfadministration of DMPA-SC. Proficiency was rated for each step of self-administration: independently [I], with reassurance [R], with verbal instruction [V], or nurse performed [RN].Data were analyzed using descriptive and comparative statistics.Results-Thirty-five percent (19/55) of participants learned self-administration. Proficiency ratings were: chose injection site (I=78.9%, R=5.3%, V=5.3%, RN=10.5%); cleaned site (I=89.5%, RN=10.5%); assembled injection device (I=47.4%, R=36.8%, V=15.8%), self-injected (I=31.6%, R=36.8%, V=15.8%, RN=15.8%), and disposed of device (I=21.1%, R=21.1%, RN=57.9%).Conclusions-Many adolescents are interested in and capable of DMPA-SC self-administration with brief education and minimal assistance.

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Contraceptive efficacy and safety of DMPA-SC

Cited by 156 publications

References 14 publications

Contraception for Adolescents

Contraception for Adolescents

New technologies in contraception

Self-administration of subcutaneous depot Medroxyprogesterone acetate by adolescent women

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