Successful treatment of depot medroxyprogesterone acetate-related vaginal bleeding improves continuation rates in adolescents.

High discontinuation rates for depot medroxyprogesterone acetate (DMPA) in adolescents may contribute to the number of unintended pregnancies. Many cite vaginal bleeding as a reason for discontinuing DMPA use. In this study, we attempted to determine if treating DMPA-associated vaginal bleeding with monophasic oral contraceptive pills (OCP) raised continuation rates. A total of 131 patients who reported vaginal bleeding while on DMPA were included in this study and 83 were treated with monophasic OCP. Of those who received OCP, 38.7% reported that vaginal bleeding stopped completely, 51.8% reported that vaginal bleeding stopped temporarily, and 6.0% reported no change. Overall, 94% of enrolled patients who received OCP as a treatment for DMPA-associated vaginal bleeding continued DMPA use. Our findings indicate that vaginal bleeding due to DMPA can be successfully treated, leading to improvement in continuation rates.