Prolonged use of medroxyprogesterone acetate for contraception
Pena Delgado, J.; Aleman Herrera, M.; Baez Reyes, A.
Semana Medica de Mexico 98(11): 331-350
1981
ISSN/ISBN: 0185-0695 PMID: 12279435 Document Number: 393917
1025 women who had used Depo-Provera 150 mg injections for contraception for 3-8 1/2 years were studied to assess the effects of prolonged use. 24.4% were aged 25-29, 33.7% were 30-34, 25.1% were 35-39, 11.2% were 40-44, and the rest were 24 and under. 47.2% had had 5-8 pregnancies and 36.3% had had 9 or more. 78.3% had had at least 5 births. 93.4% had menstrual cycles averaging 26-32 days before treatment. 74% had used no previous contraception, 18.9% used oral contraceptives (OCs), .9% used a monthly injectable, 2.9% used another trimonthly injectable, 3.1% used IUD, and .1% each used condoms and rhythm. 58.6% had amenorrhea while using Depo-Provera and 73.5% of the others had short bleeding episodes of 1-2 days. 62% of 92 endometrial biopsies indicated varying degrees of endometrial atrophy. 5 cases of benign breast adenomas were confirmed by biopsy. 71 women complained of moderate breast tenderness. No cases of breast cancer were observed. 73% gained and 9.2% lost at least 1 kg in weight. No significant changes in blood pressure were noted. The proportion of women reporting inorgasmic sexual response increased from 50.3% at the beginning of use to 75.3% after 12-38 doses of Depo-Provera. 3 pregnancies occurred, 2 possibly resulting from faulty injection technique. A follow-up study of 80 former users for 1 year showed that 39 of 58 cases of amenorrhea resumed menses in an average time of 8-9 months, and 19 did not resume menstruation. 10 of 48 with weight changes did not return to the former weight. Nervousness, amenorrhea, and acne were the symptoms requiring the longest time to disappear. 29 of 46 women complaining of frigidity and 2 of 15 complaining of dyspareunia failed to improve. 11.2% of the 80 women terminated use to achieve pregnancy. Other factors were amenorrhea (72.5%), weight gain (60%), edema (50%), nervousness (45%), sexual problems (81.2%), and hypertension (3.7%).