DMPA: How Has the Black Box Affected Clinical Practice?

In 2004, the FDA issued a black box warning for depot medroxyprogesterone acetate (DMPA), one of the most effective contraceptive methods used in the U.S. The FDA warned that DMPA might have adverse effects on skeletal health and recommended that DMPA use be limited to 2 years unless other methods were deemed inadequate. To assess the practical effects of this warning on clinical practice, researchers surveyed members of the Florida Obstetric and Gynecologic Society.

Almost half of the 149 respondents (survey return rate, 35%) reported that they limit duration of DMPA use. Sixty-five percent order BMD testing in conjunction with DMPA use. Approximately 5% sometimes prescribe bisphosphonates solely on the basis of DMPA use.