[Effect of pretreatment counseling on discontinuation rates in women given depo-medroxyprogesterone acetate for contraception].

Objective: To investigate the effect of pre-treatment counseling on discontinuation rates of 150 mg depo-medroxyprogesterone acetate (DMPA), given for contraception.

Methods: A total of 421 women participated, 204 receiving intensive structured pre-treatment and on going counseling on the hormonal effects and probable side effects of DMPA and 217 receiving only routine counseling. All participants were followed up at every 3 months for 1 year. The primary endpoint was termination rate, secondary endpoints were frequency of medical events and reasons for termination.

Results: The most common reasons for terminating DMPA were menstrual changes. Although women in the intensive structured counseling group reported more menstrual irregularity (39.7%) than did women in the routine counseling group (26.3%), study termination rates were significantly lower in the intensively structured counseling group than in the routine counseling group. At one year, the total cumulative termination rates were 11.3% (23/204) and 42.4% (92/217), respectively (P < 0.0001). No pregnancy and serious medical events were reported.

Conclusion: Pre-treatment counseling on expected side effects increases the acceptability of DMPA.