Medroxyprogesterone acetate (Depo-Provera) use in adolescents: Uterine bleeding and blood pressure patterns, patient satisfaction, and continuation rates

Abstract

Study Objective: This study examined the utilization of medroxyprogesterone acetate (Depo-Provera) in adolescent patients to determine selected side effects, degree of satisfaction, and continuation rates.Design: The design was a retrospective chart review of 50 adolescent patients totaling 384 clinic visits and accumulating 1007 woman-months of experience on DepoProvera.Setting: The Teenage Clinic at Children's Hospital, Columbus, Ohio, was the setting for this study.Participants: The mean age was 15.6 (±2.5); racial distribution was 52% African-American and 48% white. The mean number of visits per patient was 7.4 (±7.9), ranging from 2 to 39 visits.Interventions: Each patient was given Depo-Provera for either a pre-existing medical indication or for contraception.Main Outcome Measures: Uterine bleeding patterns, blood pressure readings, patient satisfaction, and continuation rates. Results: A strong correlation was found between length of time on Depo-Provera and amenorrhea and spotting (p < 0.01). No new recordings of hypertension occurred. The majority of patients expressed overall satisfaction with Depo-Provera, and most found amenorrhea to be a positive aspect of the drug. Continuation rates exceeded 50% after 2 years and generally fell within ranges reported for adult women. No pregnancies were recorded during the course of the study.Conclusions: This study indicates that Depo-Provera can be used in an adolescent population with a high degree of acceptability and does not increase patient risk for hypertension. The likelihood of amenorrhea increases greatly with duration of treatment and does not seem to deter the continuation of its use.