Do-It-Yourself DMPA

For more than 50 years, depot medroxyprogesterone acetate (DMPA) has been popular around the world as a 150-mg intramuscular (IM) injection. When used consistently, DMPA provides highly effective contraception; however, typically only half of women return to clinic for the required four shots per year. In the U.S., prefilled syringes intended for subcutaneous injection of DMPA have been available since 2004. Although subcutaneous DMPA is not FDA-approved for self-administration, this formulation provides lower peak levels and more stable blood levels at a lower dose of 104 mg.

A recent pharmacokinetic study of 150-mg IM DMPA showed that higher DMPA exposure, which likely delays return to fertility, appears to also be associated with greater …