Efficacy, side-effect profile, and continuation of depot medroxyprogesterone acetate as a spacing contraceptive: a prospective hospital-based observational cohort study.
DOI:
https://doi.org/10.51168/kzjfxf23Keywords:
Depot medroxyprogesterone acetate, injectable contraception, DMPA, compliance, continuation, side effects, postpartum contraception, post-abortal contraceptionAbstract
Objective:
To evaluate the contraceptive efficacy, side-effect profile, acceptance, and continuation of intramuscular depot medroxyprogesterone acetate among women choosing temporary contraception.
Methods:
This prospective, hospital-based observational cohort study was conducted in the Department of Obstetrics and Gynaecology at CKM Government Maternity Hospital, Warangal. Eligible postpartum, post-abortal, and interval clients who selected depot medroxyprogesterone acetate after counselling were enrolled consecutively during a 2-month recruitment period. One hundred women received 150 mg intramuscular depot medroxyprogesterone acetate and were followed for repeat injections, side effects, attrition, and pregnancy. Frequencies, percentages, and chi-square tests were used.
Results:
Most women were aged 21-25 years (62.0%), followed by 26-30 years (29.0%). Primigravida women formed the largest group (58.0%). DMPA was initiated most often in the postpartum period (53.0%), followed by post-abortal (30.0%) and interval initiation (17.0%). Follow-up declined progressively, with 42.0% returning after the first injection, 29.0% after the second, 18.0% after the third, and 11.0% after the fourth. Irregular bleeding was the most commonly reported side effect (48.0%), followed by amenorrhea (30.0%), weight gain (8.0%), and headache (3.0%). Side effects were the leading reason for attrition (47.0%). No pregnancy was recorded during the study follow-up, giving an observed Pearl Index of zero in this cohort. Age group was significantly associated with timing of injection (chi-square 18.86, p=0.004), while age-wise differences in specific side effects and attrition reasons were not statistically significant.
Conclusion:
Depot medroxyprogesterone acetate showed complete observed contraceptive efficacy in this cohort, but continuation decreased with successive injections. Menstrual changes, particularly irregular bleeding and amenorrhea, were the main tolerability concerns and contributed substantially to attrition.
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Copyright (c) 2026 Vidya Rani Dasari, Swetha Reddy Sambireddy, Laxmi Malladi (Author)
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