Early experience with the contraceptive use of depot medroxyprogesterone acetate in an inner-city clinic population.
Fam Plann Perspect
; 28(4): 174-8, 1996.
Article
en En
| MEDLINE
| ID: mdl-8853283
ABSTRACT
PIP: An exploratory study of 261 US women who initiated use of depot medroxyprogesterone acetate (DMPA) between December 1992 and June 1994 at a hospital- or community-based clinic in New York City highlighted the importance of side effects to method discontinuation. The mean age of DMPA users was 25 years; 70% were unmarried and 84% were Medicaid recipients. At the time of first injection, 58% were using no contraceptive method. At telephone interview, the average time since first injection was 8.6 months. The continuation rate was 81% at 3 months, 63% at 6 months, 52% at 9 months, and 42% at 12 months. When these rates were adjusted to assume that the 37 women who were not locatable for follow-up had discontinued, they became 74%, 53%, 39%, and 30%, respectively. There was no variation in discontinuation rates on the basis of age, parity, marital status, insurance status, number of pregnancies or abortions, postpartum status, or residence. Among the 96 discontinuers for whom data were available, the most frequently cited reasons were abnormal bleeding (30%), weight gain (24%), and nausea (12%). The percentage of women with amenorrhea was 34% at 3 months, 43% at 6 months, 66% at 9 months, and 60% at 12 months. Among adults, the risk of discontinuation was highest in the 3 months after the second injection; in contrast, the risk of discontinuation among adolescents increased steadily during the first year of use. Given the strong association between DMPA side effects and discontinuation, clinic staff are urged to pursue interventions such as estrogen therapy for amenorrhea and nutrition and exercise counseling for weight gain.
Palabras clave
Acceptor Characteristics; Acceptors; Americas; Biology; Body Weight; Contraception; Contraception Continuation; Contraception Termination; Contraceptive Agents, Female--side effects; Contraceptive Agents, Progestin--side effects; Contraceptive Agents--side effects; Contraceptive Methods; Contraceptive Usage; Depo-provera--side effects; Developed Countries; Diseases; Economic Factors; Family Planning; Family Planning Programs; Injectables; Low Income Population--women; Medroxyprogesterone Acetate--side effects; Menstruation Disorders; New York; North America; Northern America; Physiology; Research Methodology; Sampling Studies; Social Class; Socioeconomic Factors; Socioeconomic Status; Studies; Surveys; United States
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Acetato de Medroxiprogesterona
/
Anticonceptivos Femeninos
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Equity_inequality
Límite:
Adolescent
/
Adult
/
Female
/
Humans
/
Pregnancy
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Fam Plann Perspect
Año:
1996
Tipo del documento:
Article
País de afiliación:
Estados Unidos
Pais de publicación:
Estados Unidos