ABSTRACT
In the United Kingdom, the only injectable licensed for long-term use is Depot medroxyprogesterone acetate (DMPA) – given as Depo-Provera, 150 mg intramuscularly or Sayana Press, 104 mg subcutaneously. There is a weak association between cervical cancer and use of DMPA for 5 years or longer, but this could be the result of confounding factors such as number of sexual partners and Human papillomavirus exposure. Reassuringly, the overall risk of cancer seems, from World Health Organization studies, to be reduced by DMPA use. DMPA is one of the most effective among the reversible methods, with a ‘perfect use’ failure rate of 0.2 in the first year of use. Women in the latter group take longer to regain their fertility on ceasing DMPA. Most DMPA users have estradiol levels similar to the early to mid-follicular phase, but they are decidedly low for some women in the fertile years.
