Medroxyprogesterone side effects after stopping

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Side Effects of Medroxyprogesterone After Stopping: An Overview

Introduction to Medroxyprogesterone and Its Use

Medroxyprogesterone acetate (DMPA), commonly known as Depo-Provera, is a long-acting contraceptive administered via intramuscular injection every three months. It is widely used due to its convenience and effectiveness in preventing pregnancy. However, discontinuation rates are high, primarily due to side effects experienced during and after its use Picardo2006Dianat2019Paul1997.

Common Side Effects Leading to Discontinuation

Menstrual Irregularities

One of the most frequently reported side effects of DMPA is menstrual irregularities. These include amenorrhea (absence of menstruation) and unpredictable bleeding patterns. Studies indicate that between 25% and 60% of women discontinue DMPA due to these menstrual disturbances Picardo2006Paul1997Jeppsson1972. These irregularities can persist for several months after stopping the injections, causing significant inconvenience and concern for many women Picardo2006Powell1971.

Weight Gain

Weight gain is another common reason for discontinuation. Reports suggest that 6% to 43% of women stop using DMPA due to weight gain Picardo2006Paul1997Jeppsson1972. This side effect can be particularly distressing and may take time to reverse after discontinuation.

Mood Changes and Headaches

Mood changes and headaches are also cited as reasons for stopping DMPA, although the evidence is inconsistent. Some studies report a significant number of women experiencing these side effects, while others find no strong association Dianat2019Paul1997. These symptoms can persist for some time after stopping the injections, affecting overall well-being.

Long-Term Effects After Discontinuation

Return to Fertility

Fertility can take some time to return after stopping DMPA. While some women may conceive within a few months, others may experience a delay in the return of regular ovulation and menstruation. Studies show that conception occurs within 12 months for over 60% of women, but for some, it may take longer Hyjazi1985Powell1971Jeppsson1972.

Unintended Pregnancies

The risk of unintended pregnancies increases after stopping DMPA, particularly if alternative contraceptive methods are not promptly adopted. One study reported a 20% unintended pregnancy rate within nine months of discontinuation .

Importance of Counseling

Effective counseling before and during the use of DMPA can significantly impact continuation rates and user satisfaction. Structured counseling that includes detailed information about potential side effects and what to expect can reduce discontinuation rates and help women make informed decisions about their contraceptive choices Dianat2019Lei1996.

Conclusion

Medroxyprogesterone acetate is an effective contraceptive method, but its use is often discontinued due to side effects such as menstrual irregularities, weight gain, and mood changes. These side effects can persist after stopping the injections, and fertility may take time to return. Proper counseling and management of expectations are crucial in helping women navigate these challenges and make informed decisions about their reproductive health.

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Most relevant research papers on this topic

Pharmacist-administered depot medroxyprogesterone acetate.

Depot medroxyprogesterone acetate (DMPA) for contraception has low compliance rates, with side effects being the most common reason for discontinuation.

2006·

6citations

·C. Picardo

Contraception·

DOI

Side Effects and Health Benefits of Depot Medroxyprogesterone Acetate: A Systematic Review.

DMPA use may cause weight gain, increased body fat mass, irregular bleeding, and amenorrhea, with limited evidence supporting decreased cancer risk and tubal infertility.

Systematic ReviewRigorous Journal

2019·

30citations

·Shokoufeh Dianat et al.

Obstetrics & Gynecology·

DOI

[Depot medroxyprogesterone acetate: clinical and metabolic effects (lipids, glucose, hemostasis)].

Medroxyprogesterone acetate (MPA) is an effective contraceptive agent with minimal side effects and no significant impact on weight, blood tension, glycemia, or lipids.

1985·

1citation

·Y. Hyjazi et al.

Journal de gynecologie, obstetrique et biologie de la reproduction

The use of medroxyprogesterone acetate for relief of climacteric symtoms

Depo-Provera is a reliable alternative to estrogen for treating climacteric symptoms in menopausal women, with only minor side effects like withdrawal bleeding and weight gain.

RCTHighly Cited

1980·

88citations

·J. C. Morrison et al.

American Journal of Obstetrics and Gynecology·

DOI

Depot medroxyprogesterone acetate: Patterns of use and reasons for discontinuation

DMPA is widely used for short periods in New Zealand, but its acceptability is limited by side effects, particularly menstrual disturbances and weight gain.

Observational StudyHighly Cited

1997·

110citations

·C. Paul et al.

Contraception·

DOI

Effects of depo-medroxyprogesterone acetate as a contraceptive agent.

Depot medroxyprogesterone acetate is a highly effective contraceptive agent with unpredictable bleeding patterns and no deleterious effect on pregnancy outcome.

Observational Study

1971·

50citations

·L. C. Powell et al.

American journal of obstetrics and gynecology·

DOI

A Randomized, Double-Blind, Placebo- Controlled, Cross-Over Trial to Assess the Side Effects of Medroxyprogesterone Acetate in Hormone Replacement Therapy

Medroxyprogesterone acetate 10 mg/day for 14 days combined with transdermal estrogen therapy does not cause consistent adverse physical or psychological effects on women for one cycle of treatment.

RCT

1991·

55citations

·C. Kirkham et al.

Obstetrics & Gynecology

Effect of pretreatment counseling on discontinuation rates in Chinese women given depo-medroxyprogesterone acetate for contraception.

Pretreatment counseling on expected side effects significantly reduces discontinuation rates in Chinese women given depo-medroxyprogesterone acetate for contraception.

Non-RCTLarge Human TrialHighly Cited

1996·

129citations

·Z. Lei et al.

Contraception·

DOI

Experience with Depo‐Medroxyprogesterone Acetate (Depo‐Provera) as a Contraceptive Agent

Depo-Provera effectively prevents pregnancy, but may cause menstrual irregularities and weight gain.

Non-RCT

1972·

9citations

·S. Jeppsson

Acta Obstetricia et Gynecologica Scandinavica·

DOI

No Adverse Effects of Medroxyprogesterone Treatment Without Estrogen in Postmenopausal Women: Double-Blind, Placebo-Controlled, Crossover Trial

Medroxyprogesterone treatment alone does not cause adverse symptoms in postmenopausal women, and it cannot explain the side effects reported by women taking combined hormones.

RCT

1994·

31citations

·J. Prior et al.

Obstetrics & Gynecology

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