Immediate monthly combination contraception to facilitate initiation of the depot medroxyprogesterone acetate contraceptive injection

Chelsea Morroni, Morgan Grams, Lorraine Tiezzi, Carolyn Westhoff

Research output: Contribution to journalArticlepeer-review

Abstract

Conventional clinical protocols specify that women initiate depot medroxyprogesterone acetate (DMPA) within 7 days of the onset of menses, and product labeling specifies initiation within 5 days. Women outside of this window should wait until next menses to begin, often leaving them with inadequate interim contraceptive protection. An alternative is for women to initiate monthly hormonal contraception immediately, as a bridge to DMPA, with a scheduled follow-up appointment about 4 weeks later. We evaluated bridge preferences and DMPA initiation among 150 women requesting DMPA who were ineligible for their first injection at the time of clinic visit due to menstrual cycle day. Ninety-eight percent (n = 147) rejected the standard protocol of waiting with condoms or abstinence in favor of a hormonal bridge method. Ninety-seven percent follow-up (n = 146) showed that 86% were satisfied with their bridge method. There were no posttreatment pregnancies, and 55% (n = 81) of participants had initiated DMPA or another long-term contraceptive within 4 weeks of their initial clinic presentation.

Original languageEnglish (US)
Pages (from-to)19-23
Number of pages5
JournalContraception
Volume70
Issue number1
DOIs
StatePublished - Jul 1 2004
Externally publishedYes

Keywords

  • DMPA
  • Depot medroxyprogesterone acetate
  • Hormonal contraception
  • Injectable contraception
  • Reproductive health services

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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