Decreasing trends in number of depot medroxyprogesterone acetate starters in Norway - a cross-sectional study.

Abstract

In this study, we examined changes in depot medroxyprogesterone acetate (DMPA) prescriptions over a time-period when new professions started prescribing, and when the method gained some negative media attention. The Norwegian Prescription Database provided data on hormonal contraception from 2006 through 2012. We estimated the annual number of DMPA users by calculating doses sold per day/1000 women and calculated, for each contraceptive method on annual basis, a proportion of defined daily doses of all hormonal contraceptives in five-year age groups at reproductive age. All analyses were done in SPSS, version 22, with Chi-square test, t-test, and survival analysis with p<0.05 as significance level. There were minor differences in overall DMPA use during the study years. The take-out rate was equivalent to 11-12/1000 women aged 15-49years. DMPA sales amounted to nearly 4% of all daily doses of hormonal contraceptives sold. General practitioners and physicians without a specialty were the major prescribers. The number of starters decreased by nearly 40% during the study years and was consistent across age groups. The average use duration among starters was 17.7 (95% CI 17.5-17.9) months (range 0-90). There were minor changes in the relative proportion of long-term users beyond 24months during the study years. DMPA plays a minor role in the overall use of hormonal contraception in Norway, even among teenagers. The number of starters is decreasing, indicating a more restrictive attitude toward first use, especially among general practitioners.