EXPERIENCES OF INJECTABLE CONTRACEPTIVE USERS IN AN URBAN SETTING

Objective: To examine method-related experiences and acceptability of depot medroxyprogesterone acetate (DMPA) among women using this contra ceptive for the first time. Methods: Five hundred thirty-six women who received an injection of DMPA from any of seventeen clinical settings in southeast Texas, United States, were followed for 1 year. At each follow-up visit, patients were asked about their experiences with DMPA during the past 3 months and their plans to use this method in the fu ture. Results: Amenorrhea, irregular bleeding, and weight gain were th e conditions reported most frequently. Reports of amenorrhea, weight g ain, and acne or skin problems increased over time, but complaints of longer periods decreased (P <.001). Two pregnancies occurred during th e study period. However, of these, one existed before the first inject ion. Depot medroxyprogesterone acetate's continuation rate at 1 year w as 28.6%. Heavier and more frequent bleeding; increased cramping, amen orrhea, weight gain, headaches, depression, and nervousness were more frequent complaints of women who discontinued DMPA (P <.05), whereas l ighter and less frequent bleeding were reported more often by those wh o continued to use this method (P < .05). Women who discontinued use o f DMPA were more likely to be married and have a concern about injecta ble contraceptives than those who continued to use this method. Conclu sion: Intolerable side effects and changes in menstrual pattern are th e most frequently indicated reasons for discontinuing DMPA use. Our re sults suggest that DMPA's 1-year continuation rate may be lower than p reviously reported.