Members of the American Academy of Pediatrics have asked the Committee on Drugs to comment on the efficacy and the indications for use of the injectable progestin, medroxyprogesterone acetate (Depo-Provera), in adolescents. The Committee has reviewed the available data about the drug and assembled several possible indications for its use in adolescents. The Committee has found no conclusive evidence that Depo-Provera is harmful to humans, and it acknowledges that there is controversy about the potential, undesirable, long-term effects of the use of Depo-Provera that cannot be resolved by the extant data. The Committee also wishes to state that the lack of availability of Depo-Provera as an approved contraceptive agent hinders the provision of care needed by some adolescents in the United States.
The Committee believes that Depo-Provera—or a similar, long-acting contraceptive agent—can be invaluable to a small, well defined group of adolescents who need effective contraception and are unable to benefit from other methods. They may be at risk of participating in sexual activity unknowingly or unwillingly, or may be sexually active by choice. Some of these adolescents are intellectually impaired and pregnancy is especially unwanted. Conventional oral contraception may be difficult for retarded teen-agers. If there is no adult who will be responsible for administering oral contraceptives or protecting the vulnerable adolescent from sexual advances or from her own inability to estimate the consequences of unprotected sexual intercourse, the use of Depo-Provera is warranted. Menstrual flow creates a major emotional disturbance or hygienic problem for a small number of intellectually impaired adolescents (or for their caretakers), and the cessation of menstrual function—so often resulting from the continued use of Depo-Provera—may be a desirable side effect.
- Copyright © 1980 by the American Academy of Pediatrics