NEW ORLEANS -- Decidual cast expulsion may occur in young patients using depot
medroxyprogesterone acetate, Stephen M.
Depot
medroxyprogesterone acetate subcutaneous (DMPA-SC) resulted in significantly smaller losses in bone mineral density (BMD) and significantly fewer menopausal symptoms than did leuprolide in the prospective, randomized, investigator-blinded study, said Dr.
* a progestin (norethindrone acetate [NEA]; depot
medroxyprogesterone acetate [DMPA]; oral
medroxyprogesterone acetate; the levonorgestrel-releasing intrauterine system [LNG-IUS; Mirena]; and the progestin-releasing implant [Implanon])
The labeling advice reflects findings from the Women's Health Initiative Memory Study (WHIMS)--a substudy of the Women's Health Initiative (WHI)--which demonstrated an increased risk of dementia in women 65 and older during 4 years of treatment with oral conjugated estrogens plus
medroxyprogesterone acetate, compared with placebo.
"AN APPEAL TO THE FDA: REMOVE THE BLACK-BOX WARNING FOR DEPOT
MEDROXYPROGESTERONE ACETATE"
In the prospective study, invasive colorectal cancer occurred in 43 of 8,506 women who received conjugated equine estrogens (0.625 mg per day) plus
medroxyprogesterone acetate (2.5 mg per day) and in 72 of 8,102 women who received placebo.
Study participants were randomly assigned to receive 0.625 mg of conjugated estrogens plus 2.5 mg of
medroxyprogesterone acetate daily or placebo and were followed for a mean of 4.1 years.
Hormonal contraceptives in the study included oral contraceptives, depot
medroxyprogesterone acetate injectables, and combined monthly injectables.
Change in bone mineral density among adolescent women using and discontinuing depot
medroxyprogesterone acetate contraception.
The Women's Health Initiative (WHI) reported increased risks of myocardial infarction, stroke, invasive breast cancer, pulmonary emboli, and deep vein thrombosis in postmenopausal women during 5 years of treatment with conjugated equine estrogens (0.625 mg) combined with
medroxyprogesterone acetate (2.5 mg) relative to placebo (see CLINICAL PHARMACOLOGY, Clinical Studies section in the full Prescribing Information).
AFTER HEAVY VAGINAL BLEEDING was diagnosed in a 49-year-old woman, her gynecologist prescribed
medroxyprogesterone acetate. Several months later, she underwent a dilation and curettage for continued bleeding.
PHILADELPHIA -- Two years of contraception with injectable
medroxyprogesterone acetate in adolescent girls was associated with an average 6.8% reduction in bone mineral density, compared with controls in an observational study of 148 teens.