Progesterone Only Injectable Contraceptives: A Five Year Review of Side Effects and Discontinuation Rate in a Teaching Hospital in Niger Delta, Nigeria

Main Article Content

Nonye-Enyidah Esther Ijeoma
Enyidah Nonyenim Solomon


Background: Progesterone only injectable contraceptives (POICs) are long acting reversible method of contraception used worldwide. Menstrual abnormalities are recognized side effects that can lead to discontinuation of these highly effective and safe contraceptives.

Objectives: To determine the prevalence rate, side effects, discontinuation rate and indications for discontinuation of Norethisteroneenanthate (noristerat) and Depot Medroxyprogesterone acetate (depoprovera) at Rivers State University Teaching Hospital (RSUTH), Port Harcourt.

Methods: A five year retrospective study of 874 clients attending family planning clinic at the RSUTH from 1st of January, 2015 – 31st of December, 2019. Their records were retrieved from the clinic and reviewed. Data was extracted, coded and analyzed using the statistical package for social sciences (SPSS) IBM version 25.0 (Armonk, NY). Chi square test was used as test of significance where applicable and a p-value <0.05 was considered statistically significant.

Results: One hundred and thirty eight clients accepted and used POICs out of 874 acceptors of contraceptives within the study period giving a prevalence rate of 15.8%.

Depot Medroxyprogesterone acetate was more preferred by the women. The modal age group was 25-34 years accounting for 86 (62.3%). Age range was 19-48 years and the modal parity was para 2. Majority of the clients had formal education, 137 (99.3%), married, 128 (92.8%) and multipara 85 (61.6%).The discontinuation rate was 31.9%and the commonest reason for discontinuation was irregular vaginal bleeding accounting for 25%.

Conclusion: The prevalence rate of POICs was low and Depot Medroxyprogesterone acetate was more popular. Majority of the discontinuation was due to the side effects of the contraceptives.

Depot medroxyprogesterone acetate, Norethisterone enanthate, side effects, discontinuation rate, RSUTH.

Article Details

How to Cite
Ijeoma, N.-E. E., & Solomon, E. N. (2020). Progesterone Only Injectable Contraceptives: A Five Year Review of Side Effects and Discontinuation Rate in a Teaching Hospital in Niger Delta, Nigeria. Asian Journal of Medicine and Health, 18(10), 110-117.
Original Research Article


Burkman R, Amnon B. Contraception and Family Planning. In: Decheney AH (Ed.). Current Diagnosis and Treatment Obstetrics and Gynaecology, Lange Medical Book, McGraw-Hill Companies, New York. 2013:928-947.

Adeyemi AS, Adekanle DA. Progestogen-only injectable contraceptive: Experience of women in Osogbo, Southwestern Nigeria. Ann Afr Med. 2012;11:27-31.

Olugbenga-Bello AI, Abodunrin OL, Adeomi AA. Contraceptive practices among women in rural communities in South-Western Nigeria. Global J Med Res. 2011;11:1-9.

Jacobstein R, Polis CB. Progestin-only contraception: Injectables and implants. Best Pract Res ClinObstetGynaecol. 2014;28:795-806.

Okpere E. Contraception and family. In: Okpere E (Ed.). Clinical Gyneacology. Benin: Uniben Press. 2005;244-74.

Ojule JD, Oriji VK, Okongwu C. A five year review of the complications of progestogen only injectable contraceptive at the University of Port Harcourt Teaching Hospital. Niger J Med. 2010; 19: 87-95.

Ezegwui HU, Ikeako LC and Obiora-OkaforNC. The use of depot medroxyprogesterone acetate injectable contraception in Enugu, Nigeria. Nigerian Medical Journal. 2013;21(3):266-271.

Hubacher D, Lopez L, Steiner MJ, Dorflinger L. Menstrual pattern changes from levonorgestrelsubdermal implants and DPMA: Systemic review and evidence-based comparisons. Contraception. 2009;80(2):113-118.

Veisi F, Zangeneh M. Comparison of two different injectable contraceptive methods. Depomedroxy progesterone acetate (DPMA) and cyclofem. J Family and Reproductive Health. 2013;7(3):109-113.

Speroff I, Darney PD. Injectable contraception. A clinical guide to contraception. (4th ed.). Philadelphia: Lippicott Williiam & Wilkins. 2005;201- 220.

Grassman BN. Managing adverse effects of hormonal contraceptive. Am Fam Physician. 2010;82(12):1499-1506.

Laryea DO, Ankobea F, Morhe ES, Amoako YA, Spangenberg K. Characteristics and contributory factors for injectable contraceptive usage among women in Kumasi, Ghana. Contraception and Reproductive Medicine. 2016;1(1):8. DOI: 1186/s40834-016-0019-0

Ferrira JM, Bottura BF, Majara PG, Ilaza M, Bahamodes l. Comparison of two strategies for the administration of injectable depomedroxy progesterone acetate among women who returned to family planning clinic at a month or six month intervals. European Journal of Contraception and Reproductive Health Care. 2016;21(5):408-411.

National Population Commission, ICF International. Nigeria Demographic and Health Survey 2013. Abuja, Nigeria and Rockville, Maryland, USA: NPC and ICF International. 2014;97.

Oranu EO, Ojule JD, Orazulike NC. Associated factors in the declining trend in the use of progesterone only injectable contraceptive in a Niger Delta University Teaching Hospital, Nigeria. Asian journal of Medicine and Health. 2017;3(4):1-8.

Abasiattai AM, Udoma EJ, Ukeme E. Depot medroxy progesterone acetate injectable contraception at the University of Uyo Teaching Hospital. Ann Afr Med. 2010;9(2):81-85.

Ijarotimi AO, Idowu BS, Sowemimo OO, Adeyemi AB, Orji EO. A review of clinical experience with progesterone only injectable contraceptives at OAUTHC, Ile Ife. Trop J Obstet. Gynaecol. 2018; 35:170 6.

Mutihir JT, Pam VC. Overview of contraceptives use in Jos University Teaching Hospital, North Central Nigeria. Niger J ClinPract. 2008;11:139-43.

Akadri AA, Odelola OI. Progestogen-only injectable contraceptive: Acceptor prevalence and client experience at Sagamu, Nigeria. Niger Postgrad Med J. 2017;24:178-81.

Njoku CO, Emechebe CI, Iklaki CU, Njoku AN, Ukaga JT. Progestogen-Only Injectable Contraceptives: The Profile of the Acceptors, Side Effects and Discontinuation in a Low Resource Setting, Nigeria. Open J Obstet Gynecol, 2016;6:189-95.

Oshodi YA, Agbara JO, Ade-Fashola OO, Akinlusi FM, Olalere HF, Kuye TO. Weight gain and menstrual abnormalities between users of Depo-provera and Noristerat. International Journal of Repro. Contracept Obstet Gynaecol. 2019;8(6):2226-2231.

Nonye-Enyidah EI, Wekere FCC, Enyidah SN. A comparison of progesterone only contraceptives at a tertiary hospital in Port Harcourt, Rivers State. European Journal of Pharmaceutical and Medical Research. 2020;7(8):142-147.

Barden-O’Fallon J, Speizer IS, Carroon M. Womens’s contraceptive discontinuation and switching behaviour in urban Senegal, 2010-2015. BMC Women’s Health. 2018;18 (1):35. Available:

Danli S, Qingxiang S, Guoweii S. A multicentred clinical trial of the long-acting injectable contraceptive Depoprovera in Chinese women. Contraception. 2000; 62(1):15-18.