Side effects and discontinuation rate of depot medroxyprogesterone acetate in a tertiary hospital, southern Nigeria

Authors

  • Esther I. Nonye-Enyidah Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Nigeria
  • Ibiebelem A. Jumbo Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Nigeria
  • Nonyenim S. Enyidah Department of Medicine, Rivers State University Teaching Hospital, Port Harcourt, Nigeria
  • Ebbi D. Robinson Department of Radiology, Rivers State University Teaching Hospital, Port Harcourt, Nigeria
  • Mazi Eke C. Ejikem Department of Obstetrics and Gynaecology, Abia State University Teaching Hospital, Aba, Nigeria

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20205217

Keywords:

Depo provera, Discontinuation rate, RSUTH, Side effects

Abstract

Background: Depot medroxyprogesterone acetate (DMPA) also known as depo provera is a highly effective, safe and long-lasting reversible contraceptive with side effects that may cause discontinuation amongst acceptors. Objective was to determine the prevalence rate, side effects, discontinuation rate and indications for discontinuation of DMPA at Rivers State University Teaching Hospital (RSUTH), Port Harcourt.

Methods: This was a retrospective study of 874 clients attending family planning clinic at the RSUTH from 1st January, 2015 to 31st December, 2019. Their records were retrieved from the clinic and reviewed. Data was extracted, coded and analyzed using the statistical package for social sciences (SPSS) IBM version 25.0 (Armonk, NY).

Results: One hundred and one clients accepted DMPA out of 874 acceptors of contraceptives within the study period giving a prevalence rate of 11.6%. The modal age group was 25-29 years accounting for 31 (30.7%). Age range was 19-47 years and the modal parity was para 2. Majority of the clients had formal education, 100 (99%), married, 94 (93.1%) and multipara 61 (60.4%). The discontinuation rate was 32.7% and the commonest reasons for discontinuation were secondary amenorrhoea and irregular vaginal bleeding with each contributing 24.2%.

Conclusions: The prevalence and discontinuation rates of Depo provera were low. Secondary amenorrhoea and irregular vaginal bleeding were the commonest side effects and reasons for discontinuation.

Author Biographies

Esther I. Nonye-Enyidah, Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Nigeria

OBGYN dept

Consultant

Ibiebelem A. Jumbo, Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Nigeria

OBGYN dept

Consultant

References

Burkman R, Amnon B. Contraception and Family Planning. In: Decheney AH, ed. Current Diagnosis and Treatment Obstetrics and Gynaecology. Lange Medical Book, McGraw-Hill Companies: New York; 2013:928-47.

Adeyemi AS, Adekanle DA. Progestogen-only injectable contraceptive: Experience of women in Osogbo, Southwestern Nigeria. Ann Afr Med. 2012;11:27-31.

Igwegbe AO, Ugboaja JO. Clinical experience with injectable progestogen-only contraceptives at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. J Med Med Sci. 2010;1:345-9.

Oranu EO, Ojule JD, Orazulike NC. Associated factors in the declining trend in the use of progesterone only injectable contraceptive in a Niger Delta University Teaching Hospital, Nigeria. As J Med Health. 2017;3(4):1-8.

Malarcher S, Meirik O, Lebetkin E, Shah I, Jpieler J, Stanback J. Provision of DPMA by community health workers: What the evidence shows. Contraception. 2011;83:495-503.

Darroch JE, Singh S. Trends in contraceptive need and use in developing countries in 2003, 2008, and 2012: an analysis of national surveys. Lancet. 2013;381(9879):1756-62.

Jacobstein R, Polis CB. Progestin only contraception: Injectables and implants. Best Pract Res Clin Obstet Gynaecol. 2014;28:795-806.

Nonye-Enyidah EI, Kasso T. A ten year review of Depot medroxyprogesterone acetate (DMPA) contraceptive use at Rivers State University Teaching Hospital (RSUTH), south Nigeria. Int J Adv Med. 2020;7(5):800-3.

Njoku CO, Emechebe CI, Iklaki CU, Njoku AN, Ukaga JT. Progestogen-only injectable contraceptives: the profile of the acceptors, side effects and discontinuation in a low resource setting, Nigeria. Open J Obstet Gynecol. 2016;6(4):189-95.

Ojule JD, Oriji VK, Okongwu C. A five year review of the complications of progestogen only injectable contraceptive at the University of Port Harcourt Teaching Hospital. Niger J Med. 2010;19:87-95.

Nonye-Enyidah E, Ejikem Mazi EC. Profile of intrauterine contraceptive device acceptors at the Rivers State University Teaching Hospital, southern Nigeria. World J Adv Res Rev. 2019;4(2):96-101.

National Population Commission, ICF International. Nigeria Demographic and Health Survey 2013. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF International; 2014:97.

Ezegwui HU, Ikeako LC, Obiora-Okafor NC. The use of depot medroxyprogesterone acetate injectable contraception in Enugu, Nigeria. Nigerian Med J. 2012;21:266-71.

Abasiattai AM, Udoma EJ, Ukeme E. Depot medroxyprogesterone injectable contraception at the Uyo Teaching Hospital, Uyo. Ann Afr Med. 2010;9(2):81-5.

Okpere E. Contraception and family. In: Okpere E, ed. Clinical Gynaecology. Benin: Uniben Press; 2005:244-24.

Balogun OR, Raji HO. Clinical experience with injectable progestogen-only contraception at university of Ilorin Teaching Hospital: a five-year review. Nigerian Postgrad Med J. 2009;16:260-3.

Lisa M, Melissa G. Contraception. In: Gibbs RS, ed. Danforth’s Obstetrics and Gynecology, Lippincott Williams and Wilkins, Philadelphia: USA; 2008:567-85.

Akadri AA, Odelola OI. Progesterone-only injectable contraceptive. Acceptor prevalence and client experience at Sagamu, Nigeria. Nigeria Postgrad Med J. 2017;24:178-81.

Barden-O’Fallon J, Speizer IS, Carroon M. Womens’s contraceptive discontinuation and switching behaviour in urban Senegal, 2010-2015. BMC Women’s Health. 2018;18:35.

Danli S, Qingxiang S, Guoweii S. A multicentred clinical trial of the long-acting injectable contraceptive Depo provera in Chinese women. Contraception. 2000;62(1):15-8.

Downloads

Published

2020-11-26

Issue

Section

Original Research Articles