Depo-Provera -- proving its innocence
Choudhury, I.R.
Indian Medical Tribune 2(11): 5
1994
ISSN/ISBN: 0971-488X PMID: 12179187 Document Number: 286930
Family planning programs are needed to address the most significant problem in India today--the population explosion. The contraceptive injectable Depo-Provera contains the synthetic progesterone depot-medroxyprogesterone acetate (DMPA) that suppresses ovulation. Considerable controversy surrounds it. Early studies on beagle dogs suggested that DMPA increased the risk of cancer. Reviews by the World Health Organization [WHO] and the International Planned Parenthood Federation show that DMPA is safe. The US Food and Drug Administration approved Depo-Provera as a contraceptive. Political controversies and misperceptions still limit women's access to Depo-Provera. The media focused on the misinformed controversies and opposition by nonmedical women's groups when Max-India launched Depo-Provera in India. The medical community has kept silent on Depo-Provera. The women's groups and other Depo-Provera critics do not follow the scientific approach to dispute its efficacy and safety. These groups believe, because of the legacy of colonial domination, that the West is forcing low-quality products into India. They also think that it increases the incidence of cancer, but the increase in a WHO study was statistically insignificant. Depo-Provera's contraceptive effectiveness is 99.7%. Demographic factors do not affect tolerance. Menstrual irregularities comprise the most common side effect but are replaced by amenorrhea after 12 months use in 50% of cases. Beneficial effects of Depo-Provera are improvement of hemoglobin levels, protection against uterine cancer, and relief of premenstrual syndrome and dysmenorrhea. It is reversible (93% pregnancy rate 18 months after discontinuation). The Health Ministry has not approved Depo-Provera for the national family planning program but has for private physicians. The Indian Council for Medical Research has conducted clinical trials of Depo-Provera and their results will determine whether or not it will be approved for the national program.