Depo subQ: Birth Control & Endometriosis

Most of you are probably already familiar with Depo-Provera, the birth control shot. But did you know there's a new formulation, Depo subQ, with 30% less hormone? [The active ingredient is medroxyprogesterone acetate; Depo-Provera has 150 mg, and Depo subQ has 104 mg.]

The good news is that, in addition to pregnancy protection, Depo subQ is also approved for treating endometriosis pain:

Subcutaneous medroxyprogesterone acetate has been approved for the treatment of endometriosis-related pelvic pain. It is the first new treatment to be approved for this indication in 15 years.

Depo subQ provera 104 (DMPA-SC), which contains 104 mg medroxyprogesterone acetate, treats endometriosis pain as effectively as leuprolide acetate, but is associated with significantly less bone loss and fewer vasomotor symptoms, according to data provided by Pfizer Inc., which manufactures the agent.

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Administered by subcutaneous injection four times a year (every 12-14 weeks), DMPA-SC halts menstruation, which results in thinner, more compact endometrial tissue, the company said. This in turn halts the growth of endometrial implants, relieving endometriosis-associated pain.

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The 18-month study included 274 women aged 18-49 years who had diagnoses of endometriosis-associated pelvic pain. They were randomized to 6 months of treatment with either DMPA-SC (104 mg every 3 months) or leuprolide (11.25 mg IM every 3 months), and 12 months of follow-up.

There were no significant differences in pain symptom reduction. Women in both groups showed some bone mineral density declines at the end of treatment, but the mean losses were significantly less for women taking DMPA-SC in both the femur (0.3% vs. 1.65%) and the spine (1.1% vs. 3.95%).

In women who had been taking DMPA-SC, bone mineral density return to pretreatment levels 12 months after discontinuing treatment. Those who had been taking leuprolide showed continued bone mineral density losses of 1.3% in the femur and 1.7% in the spine.

DMPA-SC was also associated with significantly fewer vasomotor symptoms, especially hot flashes.