Physical findings and symptoms of depot medroxyprogesterone acetate use in adolescent females

Abstract

Study objective: To document physical and symptomatic changes in adolescent females using depot medroxyprogesterone acetate (DMPA) for contraception.

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

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

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

Interventions: 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.

Main outcome measures: 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.

Conclusion: Despite the documented side effects, DMPA is an effective, acceptable contraceptive for some adolescent females who are at high risk for pregnancy.