Asian workshop recommends injectables

Injectable contraceptives are now in use in over 65 countries, including 15 developed nations. At the 1st Asian Regional Workshop on Injectable Contraceptives, held in Thailand in May, this fact was underlined and the conclusion reached that it was time that other countries should review the acceptability of and need for injectable contraceptives in the context of their own national family planning programs. Over 50 people from 11 countries, including Bangladesh, India, Indonesia, the Philippines, Sri Lanka, and Thailand, took part. The workshop was also attended by IPPF's deputy medical director, Dr. Pramilla Senanayake. The largest clinical experience in the use of injectable contraceptives is in Asia, and the participants of the workshop were able to meet 10 of the Thai women who had had the injectable, Depo-Provera, continuously for over 10 years. These women had not missed a single injection, and had had no serious side effects, nor any unwanted pregnancies during this time. In a discussion on the recent decision of the U.S. Food and Drug Administration (FDA) to refuse a license for Depo-Provera in the U.S., it was pointed out that on 2 successive occasions Depo-Provera had been recommended for approval to the FDA by its own Obstetric and Gynecological Advisory Committee. (The membership of this advisory committee was made up of U.S. experts in obstetrics and gynecology.) Medical data were considered which showed that the return of fertility with Depo-Provera was comparable to that with oral contraceptives or IUDs, and method failure extremely low. On the evidence now available the workshop agreed that on the grounds of safety, exceptional use-effectiveness, and acceptability, injectable contraceptives had a valuable role to play in family planning. No serious adverse effects had been reported, freedom from metabolic effects was important, and earlier concern about the return of fertility after discontinuation had been dispelled. The current evidence on the safety of injectables did not indicate that this method would be less safe than oral contraceptives or IUDs.