Clinical experience with progestogen only injectable contraceptive in a tertiary institution in southern Nigeria: a ten year review

Abstract

Background: Progestogen-only injectable contraceptive (POIC) is reversible and widely accepted contraceptive method. Although commonly associated with menstrual irregularities, it seems a common choice among contraceptive users.

Objective: To determine the socio-demographic characteristics of acceptors, prevalence rate, safety profile and efficacy of injectable progestogen only injectable contraceptives in Port Harcourt, southern Nigeria.

Design: Retrospective, hospital based study.

Setting: Family Planning Clinic, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.

Subjects: One thousand and seventy five women who accepted and used progestogenonly injectable contraceptives between 1st January 2004 and 31st December, 2013.

Results: There were 1075 (32.15%) acceptors of POIC out of the 3481 total acceptors of contraception during this period. Six hundred and seventy seven (62.98%) used depot medroxyprogesterone acetate while 398 (37.02%) women used norethisteroneenanthate. Up to 614 (57.1%) clients used it to space pregnancies while 461 (42.9%) used it for ‘terminal’ contraception. Secondary amenorrhoea was the most common side effect occurring in 781 (72.7%) women. Eight hundred and fifty six (79.6%) were lost to follow up while 57 discontinued POIC use due to desire for pregnancy, implant insertion and complications such as weight gain, giving a discontinuation rate of 5.30%. No pregnancy was reported among these women during this period, giving a pearl pregnancy index of zero.

Conclusion: Progestogen only injectable contraceptive is still a common contraceptive option in our centre. Though efficacy and safety profile is relatively high, acceptance is dropping.