Injectable Contraceptive (Depot Medroxyprogesterone Acetate)

DMPA is given as an intramuscular injection, which is administered every 12 weeks. Its efficacy relies on compliance with a typical use failure rate of 3 to 6% and perfect use of 0.3%. (10) Up to 60-90% of users will develop amenorrhea after 1 year of use. Side effects include initial breakthrough bleeding, weight gain, headaches, nausea, breast tenderness, acne and mood disorder.

In 2004, the FDA issued a black box warning stating that prolonged us of DMPA may result in significant loss of bone mineral density (BMD). Following this event, the WHO collected experts reviews concluding that DMPA is associated with a risk of reversible BMD reduction during treatment, which has not been proven to increase fracture risk. (11) On average, patients on DMPA have a weight gain of less than 2 kg per year. (12) However it has also been shown that certain populations, such as those that are obese or more sedentary, are more at risk for weight gain with DMPA. (13, 14).

DPMA during treatment:

This injectable hormonal contraceptive is a popular birth control method, which can also be used for menstrual lightening and amenorrhea. Rates of amenorrhea are about 50% after one year of use but initial irregular vaginal bleeding is common. (33, 34) About 12% of DMPA users report being amenorrhea 3 months after their initial injection. (33)

DMPA has some theoretical association with a possible increased risk of deep venous thrombosis and pulmonary embolism, although benefits usually outweigh this risk in women with active cancer.(CDC 2010). Patients who have a high risk of low blood count (including anemia and thrombocytopenia) due to their malignancy or chemotherapy regimen might not tolerate initial irregular bleeding well. They could be at risk of menorrhagia and hematoma from the injection itself.