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Depomedroxyprogesterone acetate: A poor choice for an adolescent seeking contraception?
J Pediatr Adolesc Gynecol (1999) 12:95-99
Opinions in Pediatric and Adolescent Gynecology Edited by Mary Anne Jamieson, MD, FRCS(C), Departments of OB/GYN Queen’s University, Kingston, Ontario, Canada
and Paediatrics,
Depomedroxyprogesterone Acetate: A Poor Choice for an Adolescent Seeking Contraception? Introduction Depomedroxyprogesterone acetate, marketed as DepoProvera (Pharmacia and Upjohn, Kalamazoo, MI), has been granted the labeled indication for use as a contraceptive in both Canada and the United States. Most health care professionalsproviding care to adolescents are very familiar with its beneficial features in this context. Depomedroxprogesterone acetate provides excellent efficacy and effectiveness. The dosing regimen of 150 mg intramuscularly every 12 weeks reducesthe demand on an adolescent for compliance compared with that for many other appropriate options. Furthermore, it is generally accepted that more than 60% of consistent userswill achieve amenorrheaand, with proper explana-
Depo-Provera:
tion and counseling,that this is a secondarybenefit. Having statedthesekey advantages,we are very fortunate to have recognized Canadian gynecologist, Dr. Richard Boroditsky, presentthe opposingview in the debateover depomedroxprogesteroneas a contraceptive in the adolescent patient. Dr. Boroditsky is well published in the area of family planning and is very involved in national practice and policy regarding contraception. But be aware: You’re about to hear from Boroditsky That Depoprovera is Risky But the data he’ll quote May not sway your vote ‘Causeteenagersare gonna get Frisky! !
An Ideal Contraceptive
for Adolescents?
R.S. Boroditsky, MD, FRCSC, FACOG, FSOGC, Departments of Obstetrics, Gynecology, Reproductive Sciences, University of Manitoba, Health Sciences Centre, Winnipeg, Manitoba, Canada
and
Adolescent Sexuality, Minor Patients, Major Problems
Ensuring the sexual health of the teenagepatient representsan enigma within a paradox. The 1995 Canadian Contraception Study’ reveals that, although teenage women are less likely to see physicians than older women, they are more likely to rely totally on physicians for health-related issues. However, when it comes to family planning and sexuality issues, they are more likely to seek advice from others. Teens are more aware of sexually transmitted diseases(STDs) and acquired immune deficiency syndrome (AIDS) than their older coun1083.3188
0 1999 Lippincott
Williams
& Wilkins,
Inc.
terparts, but the use of condomsappearsto be lower than that of unmarried 18-34-year-old women. With the initiation of sexual activity, condom use in this population does increase,but teens are often dissatisfied with this method. Dissatisfaction along with more routine and predictable sexual activity often leadsto the use of the oral contraceptive pill. As relationships progress, the number of partners increases, condom use lapses,STD rates increase,and the pill becomesthe sole method of birth control.2
Opinions in Pediatric and Adolescent Gynecology Edited by Mary Anne Jamieson, MD, FRCS(C), Departments of OB/GYN Queen’s University, Kingston, Ontario, Canada
and Paediatrics,
Depomedroxyprogesterone Acetate: A Poor Choice for an Adolescent Seeking Contraception? Introduction Depomedroxyprogesterone acetate, marketed as DepoProvera (Pharmacia and Upjohn, Kalamazoo, MI), has been granted the labeled indication for use as a contraceptive in both Canada and the United States. Most health care professionalsproviding care to adolescents are very familiar with its beneficial features in this context. Depomedroxprogesterone acetate provides excellent efficacy and effectiveness. The dosing regimen of 150 mg intramuscularly every 12 weeks reducesthe demand on an adolescent for compliance compared with that for many other appropriate options. Furthermore, it is generally accepted that more than 60% of consistent userswill achieve amenorrheaand, with proper explana-
Depo-Provera:
tion and counseling,that this is a secondarybenefit. Having statedthesekey advantages,we are very fortunate to have recognized Canadian gynecologist, Dr. Richard Boroditsky, presentthe opposingview in the debateover depomedroxprogesteroneas a contraceptive in the adolescent patient. Dr. Boroditsky is well published in the area of family planning and is very involved in national practice and policy regarding contraception. But be aware: You’re about to hear from Boroditsky That Depoprovera is Risky But the data he’ll quote May not sway your vote ‘Causeteenagersare gonna get Frisky! !
An Ideal Contraceptive
for Adolescents?
R.S. Boroditsky, MD, FRCSC, FACOG, FSOGC, Departments of Obstetrics, Gynecology, Reproductive Sciences, University of Manitoba, Health Sciences Centre, Winnipeg, Manitoba, Canada
and
Adolescent Sexuality, Minor Patients, Major Problems
Ensuring the sexual health of the teenagepatient representsan enigma within a paradox. The 1995 Canadian Contraception Study’ reveals that, although teenage women are less likely to see physicians than older women, they are more likely to rely totally on physicians for health-related issues. However, when it comes to family planning and sexuality issues, they are more likely to seek advice from others. Teens are more aware of sexually transmitted diseases(STDs) and acquired immune deficiency syndrome (AIDS) than their older coun1083.3188
0 1999 Lippincott
Williams
& Wilkins,
Inc.
terparts, but the use of condomsappearsto be lower than that of unmarried 18-34-year-old women. With the initiation of sexual activity, condom use in this population does increase,but teens are often dissatisfied with this method. Dissatisfaction along with more routine and predictable sexual activity often leadsto the use of the oral contraceptive pill. As relationships progress, the number of partners increases, condom use lapses,STD rates increase,and the pill becomesthe sole method of birth control.2