Decreasing trends in number of depot medroxyprogesterone acetate starters in Norway - a cross-sectional study

Abstract

<i>Introduction - </i>In this study, we examined changes in depot medroxyprogesterone acetate (DMPA) prescriptions over a time‐period when new professions started prescribing, and when the method gained some negative media attention.<br><br> <i>Material and methods - </i>The Norwegian Prescription Database provided data on hormonal contraception from 2006 through 2012. We estimated the annual number of DMPA users by calculating doses sold per day/1000 women and calculated, for each contraceptive method on annual basis, a proportion of defined daily doses of all hormonal contraceptives in five‐year age groups at reproductive age. All analyses were done in SPSS, version 22, with Chi‐square test, <i>t</i>‐test, and survival analysis with <i>p</i> < 0.05 as significance level.<br><br> <i>Results - </i>There were minor differences in overall DMPA use during the study years. The take‐out rate was equivalent to 11–12/1000 women aged 15–49 years. DMPA sales amounted to nearly 4% of all daily doses of hormonal contraceptives sold. General practitioners and physicians without a specialty were the major prescribers. The number of starters decreased by nearly 40% during the study years and was consistent across age groups. The average use duration among starters was 17.7 (95% CI 17.5–17.9) months (range 0–90). There were minor changes in the relative proportion of long‐term users beyond 24 months during the study years.<br><br> <i>Conclusions - </i>DMPA plays a minor role in the overall use of hormonal contraception in Norway, even among teenagers. The number of starters is decreasing, indicating a more restrictive attitude toward first use, especially among general practitioners.