depot medroxyprogesterone

Question 1

what is the depot

Answer 1

depot medroxyprogesterone is a progestogen only contraception given as an intramuscular injection
it works by suppressing ovulation and thickening cervical mucus
every 12 weeks

Question 2

contraindications for the depot

Answer 2

current breast cancer

Question 3

precautions for the depot

Answer 3

unexplained vaginal bleeding before investigation of the cause
past breast cancer
severe cirrhosis
hepatocellular adenoma or malignant liver tumour
multiple risk factors for cardiovascular disease (eg. smoking, diabetes, hypertension, obesity)
hypertension, with vascular disease
history of ischaemic heart disease, stroke or ischaemic attack

Question 4

cardiovascular disease risk

Answer 4

theoretical unproven risk of cardiovascular disease

Question 5

advantages of depot

Answer 5

very effective
minimal user involvement
medium duration
cost effective
discreet
suitable for quickstart
safe immediately post partum and during breastfeeding
good alternative when oestrogen is contraindicated
no drug interactions
induces ammenorrhea in 50-70% of users
improves dysmennorhea
available on PBS

Question 6

disadvantages

Answer 6

altered bleeding patterns
delayed return of fertility after stopping
relatively low continuation rate
weight gain, obese adolescents at higher risk
loss of bone mineral density
headaches, mood changes, breast tenderness, loss of libido, acne

Question 7

depot is immediately effective if

Answer 7

started day 1-5 of a regular menstrual cycle
started less than 21 days post partum
started within 5 days of an abortion
repeating the injection
switching from an etonogestrel implant
takes 7 days to become effective at all other times

Question 8

how often is the injection needed

Answer 8

every 12 weeks

Question 9

depot for older women

Answer 9

recommended that women over 50 switch to a different method of contraception
harms outweigh benefits at this age

Question 10

is depot safe while breastfeeding

Answer 10

yes