Physical findings and symptoms of depot medroxyprogesterone acetate use in adolescent females.
OBJECTIVE
To document physical and symptomatic changes in adolescent females using depot medroxyprogesterone acetate (DMPA) for contraception.


METHODS
A 30-month prospective experimental study using a convenience sample of subjects.


METHODS
A pediatric primary care clinic in Milwaukee, Wisconsin that serves an urban population of low socioeconomic status.


METHODS
A mostly African-American group of 53 patients (mean age 16.5 +/- 1.3 years).


METHODS
Subjects received 150 mg DMPA intramuscularly in either the deltoid or gluteus muscle. The first two DMPA injections were given 6-8 weeks apart in an effort to decrease menstrual irregularity. Subsequent injections were given every 3 months. A questionnaire was administered at each visit to document physical and symptomatic changes.


METHODS
Included weight change, frequency and amount of menstrual bleeding, and perceived side effects and satisfaction both documented with a 5-point Likert scale.


RESULTS
At 5, 11, and 17 months of DMPA use, 75%, 40%, and 19% of subjects continued DMPA. The most commonly perceived side effects were weight gain (27%), headache (25%), irregular periods (24%), fatigue (23%), abdominal pain (18%), and decreased sexual desire (15%). Significant weight gain was noted with an average increase of 6.0 +/- 6.0 kg at 11 months of DMPA use and 9.0 +/- 5.4 kg at 17 months. No menstrual bleeding was experienced by 30%-40% of adolescents in any 3-month injection period, and those who bled averaged 8-13 days of bleeding between injections. No pregnancies occurred and 87% of patients were either satisfied or very satisfied with DMPA as a method of contraception.


CONCLUSIONS
Despite the documented side effects, DMPA is an effective, acceptable contraceptive for some adolescent females who are at high risk for pregnancy.
Matson
S C
SC
Department of Pediatrics, Medical College of Wisconsin, Milwaukee, USA.
Henderson
K A
KA
McGrath
G J
GJ
D000293:Adolescent; D001741:Black or African American; D000568:Amenorrhea; D003271:Contraceptive Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage* / Q000009:adverse effects; D017060:Patient Satisfaction; D011247:Pregnancy; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D015430:Weight Gain
D003271:Contraceptive Agents, Female; D017258:Medroxyprogesterone Acetate