DMPA use needs better side-effect management.

In March at a meeting in Hanoi a mid-term review of the first year of a 2-year longitudinal study of depot medroxy progesterone acetate (DMPA) use in 507 women at 6 study sites in Viet Nam indicated that bleeding and headaches during the first 3 months were of major concern and were major causes of discontinuation. The study was conducted in Ninh Binh and Song Be provinces beginning in June 1996 by the Ministry of Health the National Committee for Population and Family Planning (NCPFP) and the Vietnam Womens Union; the World Health Organization/Human Reproduction Programme (WHO/HRP) the United Nations Population Fund (UNFPA) GTZ (Vietnam) and ICOMP were also involved. The average age of users was 32.5 years; the average number of living children per woman was 2.8. 83% did not want more children. 97% were Kinh ethnic majority nationals and had attended school. They reported that they were well informed about family planning and sources of supply; sources of family planning information included friends relatives television and health workers. The average number of contraceptive methods used before was 2.4. 67% of the women had used an IUD 21% had used injectables and 36% had used induced abortion or menstrual regulation (MR). 33% were dissatisfied with other methods because of the possibility of unwanted pregnancy. 75% had heard about DMPA before going to clinics; many had decided to use the method because they felt it was safe. In its second phase the study will continue to follow the DMPA users for up to 12 months to determine the continuation rate and the reasons for discontinuation.