Contraceptive Use—Efficacy Study Utilizing Medroxyprogesterone Acetate  Administered As An Intramuscular Injection Once Every 90 Days

Schwallie, Paul C.; Assenzo, Joseph R.

doi:10.1016/s0015-0282(16)39669-8

Cited by 157 publications

(32 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Mood changes or depressive symptoms such as anorexia and fatigue have been reported in 1-5% of DMPA users in large studies and in 8.9% of users in the first three months in the Houston cohort, consistent with the rate in the current study [8,11,12]. Most reports do not include the baseline rate of depressive symptoms, so many of these symptoms may antedate the use of DMPA.…”

Section: Discussionsupporting

confidence: 82%

Safety and tolerability of depot medroxyprogesterone acetate among HIV-infected women on antiretroviral therapy: ACTG A5093

et al. 2008

View full text Add to dashboard Cite

Background-Concomitant use of antiretrovirals (ARV) and hormonal contraceptives may change the metabolism of each and the resulting safety profiles. We evaluated the safety and tolerability of depot medroxyprogesterone acetate (DMPA) among women on ARV.Study Design-HIV-infected women on selected ARV regimens or no ARV were administered DMPA 150 mg intramuscularly and evaluated for 12 weeks for adverse events, changes in CD4+ count and HIV RNA levels, and ovulation.Results-Seventy evaluable subjects were included, 16 on nucleoside only or no ARV, 21 on nelfinavir-containing regimens, 17 on efavirenz-containing regimens, and 16 on nevirapinecontaining regimens. Nine grade 3 or 4 adverse events occurred in 7 subjects; none were judged related to DMPA. The most common findings possibly related to DMPA were abnormal vaginal bleeding (9, 12.7%), headache (3, 4.2%), abdominal pain, mood changes, insomnia, anorexia, and fatigue, each occurring in 2 (2.9%) subjects. No significant changes in CD4+ count or HIV RNA levels occurred with DMPA. No evidence of ovulation was detected, and no pregnancies occurred. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conclusions-The clinical profile associated with DMPA administration in HIV-infected women, most on ARV, appears similar to that seen in HIV-uninfected women. DMPA prevented ovulation and did not affect CD4+ counts or HIV RNA levels. In concert with previously published DMPA/ ARV interaction data, these data suggest that DMPA can be used safely by HIV-infected women on the ARV studied. Conflicts of interest

show abstract

Section: Discussionsupporting

confidence: 82%

Safety and tolerability of depot medroxyprogesterone acetate among HIV-infected women on antiretroviral therapy: ACTG A5093

et al. 2008

View full text Add to dashboard Cite

show abstract

“…Some studies report no weight changes unique to DMPA users [7][8][9][10] while others find average weight gains as high as 9 kg in 2 y or less. 6,[11][12][13][14] Most of these studies have used either retrospective designs or did not include controls in the prospective design. Thus, it is difficult to discern if the weight changes, or lack thereof, are due to the potential weight-related dropout bias in the retrospective studies, or to the failure to discriminate DMPA-related weight gain from usual weight gain in uncontrolled prospective studies.…”

Section: Introductionmentioning

confidence: 99%

Weight, fat mass, and central distribution of fat increase when women use depot-medroxyprogesterone acetate for contraception

et al. 2005

View full text Add to dashboard Cite

OBJECTIVE:To compare longitudinal changes in weight, body fat, and ratio of central to peripheral fat mass among first-time depot-medroxyprogesterone acetate (DMPA) users to women using no hormonal contraception, and to evaluate user characteristics associated with that change. DESIGN: Prospective longitudinal study. SUBJECTS: Healthy women, aged 18-35 y, using DMPA for contraception (n ¼ 178) and women using no hormonal contraception (n ¼ 145). MEASUREMENTS: Weight, body fat, and the central distribution of fat, measured at 3-month intervals for 30 months, by electronic scale and dual-energy X-ray absorptiometry (DEXA). The ratio of central to peripheral distribution of body fat was computed by dividing the body fat in the conventional DEXA trunk region of interest (ROI) by the ROI's that encompass the arms, hips and legs. RESULTS: Women using DMPA had a significantly greater increase in all measures of fatness than women using no hormonal method of contraception (Po0. In contrast, weight, fat mass and the ratio of central to peripheral fat mass of control participants remained virtually unchanged over the same time period. Women with higher baseline physical activity levels had a smaller increase in body fat (P ¼ 0.003) and the fat ratio (P ¼ 0.03), but not weight (P ¼ 0.48). No other user characteristics including, smoking, past oral contraceptive use or previous pregnancies predicted change in level of fatness. CONCLUSIONS: This study has demonstrated a change in body composition toward greater fatness and toward a central redistribution of fat among DMPA users as compared to controls and provides important information to be used when counseling women regarding contraceptive methods. Given the potential long-term implication of these changes, further study is recommended to determine whether the gains in fatness are reversed following DMPA discontinuation and to examine the role of progestins in the development and maintenance of obesity.

show abstract

“…irregular cycle, spotting) [1]. Other side-effects have also been reported: in one large study, headaches were reported among 17% of users; nervousness in 11% and depression in 2% [2]. Recent reports stress the infrequent occurrence of these latter problems [3].…”

Section: Introductionmentioning

confidence: 99%

Beliefs about Depo-Provera among three groups of contraceptors

et al. 1996

View full text Add to dashboard Cite

This article examines the beliefs about Depo-Provera held by three groups of contraceptors utilizing urban family planning clinics in the United States (n = 836). Patients choosing Depo-Provera, oral contraceptives, and Norplant were asked about their beliefs regarding Depo-Provera in the following four domains: effectiveness in preventing pregnancy, convenience, side-effects, and risk to health; and also for their perceptions regarding the physical discomfort and cost associated with the method. Findings reveal that patients choosing the pill and Norplant give Depo-Provera significantly lower ratings for both convenience and effectiveness than do Depo-Provera acceptors. Given the documented effectiveness of Depo-Provera, this is a potential cause for concern. Moreover, Norplant and pill choosers are most likely to hold inaccurate beliefs regarding both the cost of Depo-Provera, and certain side-effects associated with its use. Although more than half of all patients believe the Depo-Provera would cause menstrual changes and weight gain, it is noteworthy that the proportions are not higher, given their known association with the method. Knowledge about the likelihood of these side-effects is essential, particularly for those choosing Depo-Provera. Implications for physicians, counselors, and other family planning professionals are discussed.

show abstract

Contraceptive Use—Efficacy Study Utilizing Medroxyprogesterone Acetate Administered As An Intramuscular Injection Once Every 90 Days

Cited by 157 publications

References 13 publications

Safety and tolerability of depot medroxyprogesterone acetate among HIV-infected women on antiretroviral therapy: ACTG A5093

Safety and tolerability of depot medroxyprogesterone acetate among HIV-infected women on antiretroviral therapy: ACTG A5093

Weight, fat mass, and central distribution of fat increase when women use depot-medroxyprogesterone acetate for contraception

Beliefs about Depo-Provera among three groups of contraceptors

Contact Info

Product

Resources

About