Medroxyprogesterone acetate as a contraceptive for female drug addicts

A study of 69 female drug addicts is presented who have been given depomedroxyprogesterone acetate (DMPA) as a contraceptive for 1 680 woman-months. No pregnancies were reported during the treatment period with DMPA. After stopping treatment, 60 pregnancies with 43 births were recorded, 12 with low birth weight. In 3 cases pregnancy ended with spontaneous abortion, and in 14 cases legal abortion were performed. During the study, regular liver function tests revealed no hepatotoxic effects from DMPA in this group of patients where one would expect a high frequency of a serum hepatitis. Neither coagulation nor blood pressure were affected. The most frequent side effect was amenorrhoea, which seems to be accepted well in this group. Metrorrhagia is often a reason for withdrawing the drug. A very high frequency of venereal or other gynaecological infection is presumably the explanation for the very high number of atypical inflammation cells found at vaginal cytological examination. In the series, two cases of carcinoma in situ have been demonstrated by cervical biopsy. Both cases are possibly related to these women's early sexual activity, very promiscuous life and to the poor environment of the drug addict.