Early Experience with the Contraceptive Use of Depot Medroxyprogesterone Acetate in an Inner-City Clinic Population

Abstract

There are few data on the experience of American women with the injectable depot medroxyprogesterone acetate (DMPA) since its recent approval by the Food and Drug Administration for contraceptive use in the United States. An exploratory study was conducted using chart reviews and telephone interviews of 261 women who initiated DMPA use between December 1992 and June 1994 at either a hospital-based (48%) or community-based (49%) clinic in New York City. Most DMPA users were single (70%), had had at least one birth (88%), had had at least one abortion (67%) and had ever practiced contraception (75% of those with available data). Life-table DMPA continuation rates were 63% at six months and 42% at 12 months and were not affected by the users' age, marital status, pregnancy history, clinic site or proximity of residence to the clinic. Among adults, the risk of DMPA discontinuation was highest during the three-month period following the second injection, while among adolescents, this risk increased throughout the duration of use. The most commonly reported reasons for method discontinuation were side effects, primarily menstrual irregularities (30%) and weight gain (24%).

Depo Now: Preventing Unintended Pregnancies among Adolescents and Young Adults

“…Given the effectiveness of this method relative to user requirements and the high rates of user satisfaction at the 3-and 6-month follow-up, this is particularly disappointing. One-year continuation rates have been reported to be between 32% and 45% among nonparenting adolescent samples [16,17], whereas 6-month reported rates in nonpostpartum adolescent samples range between 63% and 70% [17,18]. As expected, among those who discontinued, the most frequently reported side effects leading to their discontinuation were irregular menstrual bleeding, weight gain, and breaking up with their partners.…”

Reasons for discontinuation of depot medroxyprogesterone acetate

“…Based upon the results of the study, a high proportion of subjects discontinued the DMPA after one or two injections (41.3% and 19.9%, respectively).Potter et al [2] and Polaneczky et al [6] also reported that 44% of subjects discontinued the DMPA after only one injection.…”

Adolescent Use of the Monthly Contraceptive Injection

“…1 The 1992 introduction of depot medroxyprogesterone acetate (DMPA) has produced a steady stream of publications citing menstrual irregularity, weight gain, and decreased bone density as side effects that may be more prevalent and detrimental in adolescent than adult users. [2][3][4][5][6] In October 2000, the US Food and Drug Administration approved the use of a monthly contraceptive injection containing medroxyprogesterone acetate (MPA) and estradiol cypionate (E2C). The new method offered a promising alternative to women who sought the convenience of DMPA and the cycle regulation of the OCP.…”