THE CONTRACEPTIVE USE OF DEPOT MEDROXYPROGESTERONE ACETATE

Depot medroxyprogesterone acetate (DMPA) was the first popular long-acting progestogen-only contraceptive, and is used by more than nine million women worldwide. It is one of the most convenient and effective, yet readily reversible methods of contraception. Although application was first submitted to the US Food and Drug Administration in 1967 for approval to market DMPA as a contraceptive, final approval only came years later in late 1992. DMPA is now approved for marketing as a contraceptive in more than 100 countries, mainly as Depo-Provera for intramuscular use in a 150 mg dose, although several generic products are available in many countries. Many clinicians have access to DMPA as a contraceptive for the first time, and most are aware of the substantial controversy surrounding its use. This paper discusses the role of DMPA in the current array of contraceptive choices, offering guidance for the common clinical problems which may present with use. Sections cover dosage, administration, and contraceptive action; advantages and disadvantages of DMPA; controversies and DMPA; acceptability; and indications and contraindications for use