A review of clinical experience with progesterone-only injectable contraceptives at OAUTHC, Ile-Ife

Abstract

Background: Progestogen-only injectable contraceptives (POICs) remain the most popular contraceptive method in Nigeria. Considering how widely used POICs are worldwide, there is little published evidence of their safety and effectiveness. There is also a paucity of research to determine associations between the influence of age and parity and the preferred choice of POICs in women. Aim: This study was to determine the use prevalence and the influence of age and parity on the preferred choice of POIC, and also the reasons for discontinuation among users of POICs at the family planning clinics of OAUTHC, Ile-Ife. Materials and Methods: A retrospective record of 324 women who chose POICs out of a total of 1,029 clients seen at the family planning units of the hospital was collected for the period between January and December 2015. Information relevant to this study objectives was extracted using a purpose-designed proforma. Data were analyzed with SPSS version 16, and results were presented as frequencies and percentages. Pearson Chi-square test was used as test of significance where applicable and a P value Results: The prevalence of POIC during the study period was 31.49%. Depo-Provera (depot medroxyprogesterone acetate [DMPA]) was the most popular injectable preferred by the women. Age and parity had significant effects on the preferred injectable contraception with P values of 0.032 (CI 0.088-0.099) and 0.002 (CI 0.009-0.013), respectively, as younger clients with lower parity preferred Noristerat while preference for DMPA increased with age and parity. Majority (67%) did not experience any side effect; secondary amenorrhea was the most common side effect experienced by 27% of the clients. Only 34% continued with the method for the duration of study while 66% discontinued for different reasons. Conclusion: POICs are very effective and safe long-acting reversible method of contraception. While DMPA may be the more popular overall choice, norethisterone enanthate (NET-EN) is preferable in younger women of low parity.