|March 2008 · Vol. 20, No. 03
COMMENT & CONTROVERSY
Isn’t DMPA appropriate in sickle cell disease?
“Contraception for medically complex patients,” by Daniela A. Carusi, MD, MSc
I am surprised that Dr. Carusi recommends progestin-only pills for contraception for the woman described in her article who had sickle cell disease and a history of mild stroke. The article states that depot medroxyprogesterone acetate (DMPA) “may suppress ovarian function and is classified as [World Health Organization] category 3.” (Category 3 is reserved for conditions in which theoretical or proven risks usually outweigh the advantages of the contraceptive method.)