Sexual Infections with Depo Provera? (cont.)

One behavioral question is "Might the women who opt for Depo Provera do so because they engage in riskier sex?"

Barbara K. Hecht, Ph.D.
Frederick Hecht, M.D.
Medical Editors,

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Depo Provera Appears to Increase Risk for Chlamydial and Gonococcal Infections

The injectable contraceptive depot-medroxyprogesterone acetate (DMPA) appears to increase a woman's risk of acquiring the sexually transmitted infections chlamydia and gonorrhea by approximately three fold when compared to women not using a hormonal contraceptive, according to a study jointly funded by the National Institute of Child Health and Human Development(NICHD) at the National Institutes of Health and the U.S. Agency for International Development's Office of Population and Reproductive Health.

DMPA is marketed under the product name Depo Provera. The contraceptive is injected into either the arm or buttocks four times a year.

The study was unable to determine why DMPA might increase the risk for these infections.

"These findings underscore the need to counsel all sexually active women who use DMPA and who are not in a mutually monogamous relationship to use condoms consistently and correctly," said the study's first author, Charles Morrison, Ph.D., of Family Health International in Research Triangle Park, North Carolina. "For sexually active women not in a mutually monogamous relationship, limiting the number of partners may also help to reduce the risk."

The study appears in the September Sexually Transmitted Diseases.

The researchers also tested another type of contraceptive formulation, oral contraceptives containing both estrogen and progestin. The researchers concluded that oral contraceptives do not appear to significantly increase the risk of chlamydial infection and gonorrhea.

To conduct the study, the researchers recruited women from two Baltimore, Maryland area clinics. One clinic was within the city of Baltimore and served a predominantly African American clientele. The other was in the Baltimore suburb of Towson and predominantly served white, college-age women. The women chose whether they wanted to use DMPA, oral contraceptives, or a non-hormonal contraceptive method.

Of the 819 women included in the study's final analysis, 77 percent were single, 75 percent had never given birth, and 79 percent were high school graduates. Roughly 52 percent were white, 43 percent were African American, and the remaining women were of other racial or ethnic origins. Study participants ranged in age from 15 to 45 years. After enrolling in the study, they were tested for chlamydial and gonococcal infection after three, six, and 12 months.

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