Table 3 Depo-Medroxyprogesterone Acetate and Medroxyprogesterone Acetate Facts

DMPA was discovered in 1956 and approved in the USA in 1960 for treatment of endometrial and renal cancer and in 1992 as a contraceptive.

An oral tablet MPA 2.5,5 and 10 mg medroxyprogesterone acetate was approved in the US in 1959 for the treatment of metorrhagia, amenorrhea, and recurrent miscarriage.

A combination OCP was introduced in 1964 in the U.S. [brand name Provest] (10 mg MPA and 50 μg ethinylestradiol tablets) but it was discontinued in 1970.

In 2017, it was the 222nd most commonly prescribed medication in the United States, accounting for more than two million prescriptions. It is currently approved in more than 100 countries around the world and often listed among the most commonly prescribed medications [11].

Reports of serious thrombotic events in women using Depo-Provera, but not causally associated with the induction of thrombotic or thromboembolic disorders [12].

The package insert for the contraceptive Depo-MPA states: “The physician should be alert to the earliest manifestations of thrombotic disorder (thrombophlebitis, cerebrovascular disorder, pulmonary embolism, and retinal thrombosis). Should any of these occur or be suspected, the drug should be discontinued immediately.”

The WHO has recommended that the use of DMPA not be restricted. It is on World Health Organization’ s List of Essential Medicines that selects the safest and most effective medicines needed in for healthcare [13].

Bone loss after 2 years of use and weight gain are reported side effects and should be part of a risk benefit decision

Associated with a reduced frequency of seizures; does not interfere with antiepileptic mediations.

Mood changes are reported in some women on progestins including both oral and injectable MPA.

December 2004, a subcutaneous version of DMPA was approved in the USA as a contraceptive (104 mg/0.65 mL MPA); and also approved for the treatment of endometriosis-related pelvic pain.

Irregular bleeding, particularly during the first months of use, in common and can continue with prolonged treatment.

Improves blood counts in women with sickle cell anemia; used to improve iron deficiency anemia due to menstrual blood loss

Associated with a decreased risk of pelvic inflammatory disease