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. 1994 May 2;160(9):553-6.

Depo-Provera use in an Australian metropolitan practice

I S Fraser  1 , G J Dennerstein
Affiliations
  • PMID: 8164553

Depo-Provera use in an Australian metropolitan practice

I S Fraser et al. Med J Aust. .

Abstract

Objective: To review the characteristics and experience of Australian women treated with depot medroxyprogesterone acetate (DMPA) in one gynaecological practice in Melbourne since 1973.

Design: A detailed retrospective review of clinical data on 363 women treated with a total of 2298 injections of DMPA over the past 20 years.

Results: The main indication was contraception, although a substantial minority (20%) were treated with DMPA predominantly for medical indications such as endometriosis. No pregnancy occurred within three months of an injection. There was also high acceptability, with a mean of 6.3 injections per subject, and a mean overall follow-up of 43.3 months. The median delay in the return of fertility in those wishing to conceive immediately was 9.2 months. Only one patient complained of difficulty in conceiving. Menstrual bleeding disturbances only led to 7.3% of the discontinuations, although fairly frequent use of short courses of oral oestrogen (in 40% of women) was employed in the early months of DMPA treatment. Other side effects were relatively infrequent, the most common being superficial dyspareunia or reduced libido (in 8%).

Conclusions: This much maligned drug merits a legitimate place among the contraceptive choices available for Australian women. Accurate, unbiased information about the extensive worldwide experience needs to be made available to all Australian medical practitioners.

PIP: In Australia, obstetrician-gynecologists analyzed records of 363 patients, 17-50 years old, from a private practice in the northern suburbs of Melbourne, who received injections of 150 mg Depo-Provera every 12 weeks, to determine the experience of these women. Over a 20-year period (1973-1993), the women had together received a total of 2298 injections. Most women (80%) used Depo-Provera for contraception. Other common indications for Depo-Provera use were treatment of endometriosis, recurrent candidiasis, and menorrhagia. No patient conceived within 3 months of injection. The mean number of injections per patient was 6.3. The mean overall follow-up was 43.3 months. Among women who wanted to become pregnant, the median contraception interval from the end of presumed contraceptive action and pregnancy was 9.2 months (range, 1.1-20.5 months). Just 1 woman complained that it was difficult for her to conceive after Depo-Provera treatment. The most common reason for discontinued use of Depo-Provera was no further need (e.g., sterilization) or change to oral contraception (41.6%). Side effects accounted for discontinuation in 23.4% of the women. Bleeding irregularities comprised 7.3% of discontinuations. Many women (40%) sometimes had light, prolonged bleeding and received ethinyl estradiol to treat it, usually in the 1st 6-12 months of treatment. Other side effects occurred rather infrequently, the most prevalent being reduced libido or difficulty with intercourse (8%). These findings confirm that Depo-Provera is a very effective and acceptable contraceptive method. It deserves a legitimate place among the contraceptive choices available for Australian women. Australian physicians should have access to accurate, unbiased information about the extensive worldwide experience of Depo-Provera.

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