Contraception
Volume 80, Issue 1 , Pages 7-17 , July 2009

Subcutaneous DMPA vs. intramuscular DMPA: a 2-year randomized study of contraceptive efficacy and bone mineral density

  • Andrew M. Kaunitz

      Affiliations

    • Department of Obstetrics and Gynecology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL 32209, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1 904 244 3109; fax: +1 904 244 3658.
    • ,
  • Philip D. Darney

      Affiliations

    • Department of Obstetrics, Gynecology, and Reproductive Sciences, San Francisco General Hospital, University of California, San Francisco, CA 94110, USA
    • ,
  • Douglas Ross

      Affiliations

    • Pfizer Inc., New York, NY 10017, USA
    • ,
  • Kevin D. Wolter

      Affiliations

    • Pfizer Global Research and Development, New London, CT 06320, USA
    • ,
  • Leon Speroff

      Affiliations

    • Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR 97239, USA

Received 28 July 2008 ,Revised 5 February 2009 ,Accepted 5 February 2009.

References 

  1. Westhoff C. Depot-medroxyprogesterone acetate injection (Depo-Provera): a highly effective contraceptive option with proven long-term safety. Contraception. 2003;68:75–87
  2. Kaunitz AM. Depot medroxyprogesterone acetate for contraception. In:  Rose BD editors. UpToDate. Waltham (Mass): UpToDate; 2008;
  3. Nelson A. Merits of DMPA relative to other reversible contraceptive methods. J Reprod Med. 2002;47(9 Suppl):781–784
  4. Jain J, Dutton C, Nicosia A, Wajszczuk C, Bode FR, Mishell DR. Pharmacokinetics, ovulation suppression and return to ovulation following a lower dose subcutaneous formulation of Depo-Provera. Contraception. 2004;70:11–18
  5. Jain J, Jakimiuk AJ, Bode FR, Ross D, Kaunitz AM. Contraceptive efficacy and safety of DMPA-SC. Contraception. 2004;70:269–275
  6. Prabhakaran S. Self-administration of injectable contraceptives. Contraception. 2008;77:315–317
  7. Lakha F, Henderson C, Glasier A. The acceptability of self-administration of subcutaneous Depo-Provera. Contraception. 2005;72:14–18
  8. Curtis KM, Martins SL. Progestogen-only contraception and bone mineral density: a systematic review. Contraception. 2006;73:470–487
  9. Hergenroeder AC. Bone mineralization, hypothalamic amenorrhea, and sex steroid therapy in female adolescents and young adults. J Pediatr. 1995;126:683–689
  10. Gbolade BA. Depo-Provera and bone density. J Fam Plann Reprod Health Care. 2002;28:7–11
  11. Mishell DR. Pharmacokinetics of depot medroxyprogesterone acetate contraception. J Reprod Med. 1996;41(5 Suppl):381–390
  12. Clark MK, Sowers M, Levy BT, Tenhundfeld P. Magnitude and variability of sequential estradiol and progesterone concentrations in women using depot medroxyprogesterone acetate for contraception. Fertil Steril. 2001;75:871–877
  13. Cummings SR, Nevitt MC, Browner WS, et al. Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group. N Engl J Med. 1995;332:767–773
  14. Cundy T, Cornish J, Roberts H, Reid IR. Menopausal bone loss in long-term users of depot medroxyprogesterone acetate contraception. Am J Obstet Gynecol. 2002;186:978–983
  15. Karlsson MK, Ahlborg HG, Karlsson C. Maternity and bone mineral density. Acta Orthop. 2005;76:2–13
  16. Hui SL, Slemenda CW, Johnston CC. Age and bone mass as predictors of fracture in a prospective study. J Clin Invest. 1988;81:1804–1809
  17. Kaunitz AM, Arias R, McClung MR. Bone density recovery after depot medroxyprogesterone acetate injectable contraception use. Contraception. 2008;77:67–76
  18. Cundy T, Cornish J, Evans MC, Roberts H, Reid IR. Recovery of bone density in women who stop using medroxyprogesterone acetate. BMJ. 1994;308:247–248
  19. Petitti DB, Piaggio G, Mehta S, Cravioto MC, Meirik O. Steroid hormone contraception and bone mineral density: a cross-sectional study in an international population. The WHO Study of Hormonal Contraception and Bone Health. Obstet Gynecol. 2000;95:736–744
  20. Scholes D, LaCroix AZ, Ichikawa LE, Barlow WE, Ott SM. Injectable hormone contraception and bone density: results from a prospective study. Epidemiology. 2002;13:581–587
  21. Scholes D, LaCroix AZ, Ichikawa LE, Barlow WE, Ott SM. Change in bone mineral density among adolescent women using and discontinuing depot medroxyprogesterone acetate contraception. Arch Pediatr Adolesc Med. 2005;159:139–144
  22. Clark MK, Sowers M, Levy B, Nichols S. Bone mineral density loss and recovery during 48 months in first-time users of depot medroxyprogesterone acetate. Fertil Steril. 2006;86:1466–1474
  23. Kaunitz AM, Miller PD, Rice VM, Ross D, McClung MR. Bone mineral density in women aged 25–35 years receiving depot medroxyprogesterone acetate: recovery following discontinuation. Contraception. 2006;74:90–99
  24. Rosenberg L, Zhang Y, Constant D, et al. Bone status after cessation of injectable progestin contraceptives. Contraception. 2007;76:425–431
  25. Arias RD, Jain JK, Brucker C, Ross D, Ray A. Changes in bleeding patterns with depot medroxyprogesterone acetate subcutaneous injection 104 mg. Contraception. 2006;74:234–238
  26. Orr-Walker BJ, Evans MC, Ames RW, Clearwater JM, Cundy T, Reid IR. The effect of past use of the injectable contraceptive depot medroxyprogesterone acetate on bone mineral density in normal post-menopausal women. Clin Endocrinol (Oxf). 1998;49:615–618
  27. Schwallie PC, Assenzo JR. Contraceptive use-efficacy study utilizing medroxyprogesterone acetate administered as an intramuscular injection once every 90 days. Fertil Steril. 1973;24:331–339
  28. Fraser IS, Dennerstein GJ. Depo-Provera use in an Australian metropolitan practice. Med J Aust. 1994;160:553–556
  29. Weissman MM, Bland RC, Canino GJ, et al. Cross-national epidemiology of major depression and bipolar disorder. JAMA. 1996;276:293–299
  30. Belsey EM. Vaginal bleeding patterns among women using one natural and eight hormonal methods of contraception. Contraception. 1988;38:181–206
  31. Freeman S. Nondaily hormonal contraception: considerations in contraceptive choice and patient counseling. J Am Acad Nurse Pract. 2004;16:226–238
  32. Hubacher D, Goco N, Gonzalez B, Taylor D. Factors affecting continuation rates of DMPA. Contraception. 1999;60:345–351
  33. Kaunitz AM. Menstruation: choosing whether … and when. Contraception. 2000;62:277–284
  34. Nelson AL. Counseling issues and management of side effects for women using depot medroxyprogesterone acetate contraception. J Reprod Med. 1996;41(5 Suppl):391–400
  35. American College of Obstetricians and Gynecologists Committee on Practice Bulletins — Gynecology . ACOG practice bulletin no. 73: use of hormonal contraception in women with coexisting medical conditions. Obstet Gynecol. 2006;107:1453–1472
  36. World Health Organization . Technical consultation on the effects of hormonal contraception on bone health. Geneva, Switzerland: World Health Organization; 2005;
  37. Black A. Canadian contraception consensus — update on depot medroxyprogesterone acetate (DMPA): Ad Hoc DMPA Committee of the Society of Obstetricians and Gynaecologists of Canada. J Obstet Gynaecol Can. 2006;28:305–313
  38. Cromer BA, Scholes D, Berenson A, Cundy T, Clark MK, Kaunitz AM. Depot medroxyprogesterone acetate and bone mineral density in adolescents — the black box warning: a position paper of the Society for Adolescent Medicine. J Adolesc Health. 2006;39:296–301
  39. Royal College of Obstetricians and Gynaecologists National Collaborating Centre for Women's and Children's Health. Long-acting reversible contraception: the effective and appropriate use of long-acting reversible contraception [commissioned by the National Institute for Health and Clinical Excellence]. London, UK: Royal College of Obstetricians and Gynaecologists; 2005;
  40. Kaunitz AM. Depo-Provera's black box: time to reconsider?. Contraception. 2005;72:165–167
  41. Paschall S, Kaunitz AM. Depo-Provera and skeletal health: a survey of Florida obstetrics and gynecologist physicians. Contraception. 2008;78:370–376

PII: S0010-7824(09)00045-6

doi: 10.1016/j.contraception.2009.02.005

Contraception
Volume 80, Issue 1 , Pages 7-17 , July 2009

Article Tools

* Image Usage & Resolution