|August 2005 · Vol. 17, No. 8
UPDATE on CONTRACEPTION
New Developments That Are Changing Patient Care
Subcutaneous depot medroxyprogesterone acetate for birth control and endometriosis pain.
Amenorrhea increased to 55% after a year
“I discuss the black box warning with each patient.”
DMPA is the first drug in 15 years for endometriosis pain
Associate Professor Obstetrics and Gynecology University of Southern California Keck School of Medicine
Since it was approved more than 10 years ago, depot medroxyprogesterone acetate (DMPA; Depo-Provera) has gained popularity among US women, largely because it requires minimal user participation and has a failure rate of only 0.3% per year.1,2 The main limitation, from the patient’s point of view, has been the intramuscular (IM) route of injection, which requires an office visit every 12 to 14 weeks for administration.
Now a subcutaneous version of the drug is available (Depo-subQ Provera 104) that delivers a lower dose of medroxyprogesterone acetate (MPA) (104 mg versus 150 mg for the IM formulation). The subcutaneous route opens the possibility for home self-injections, and the lower dose could decrease suppression of pituitary function and ovarian estradiol production, though further study is needed.