Injectable medroxyprogesterone

A statement released by the Food and Drug Administration (FDA) concerning depot medroxyprogesterone acetate (DMPA) (Depo-Provera) found insufficient evidence linking DMPA to certain carcinoma-in-situ to withhold it from usage as a contraceptive agent. The FDA recommends usage limited to women to whom potential hazards have been fully explained, to those who cannot use other contraceptive methods, and to those who have completed childbearing. Presently 60 countries use DMPA. A recent review suggested that it is a justifiable contraceptive agent, there are few side effects other than irregular uterine bleeding and amenorrhea, and few reports of serious complications even when DMPA is used in larger doses for treatment of endometriosis or endometrial carcinoma. Evidence suggests that although the return of ovulation is slower than after discontinuing oral contraceptives or the IUD, the return rate after 1 year is high. Further evaluations are necessary concerning carcinogenicity and reversibility.