Self-administration of injectable contraceptives.

Although depot-medroxyprogesterone represents a highly effective contraceptive, its use is associated with poor continuation rates. Although the major reason for discontinuation is menstrual irregularity, the time, expense and inconvenience of clinic visits also pose a barrier to use. Self-administration of the 104-mg subcutaneous formulation might make clinic visits unnecessary. Many medications can be safely self-administered by subcutaneous injection, and patient satisfaction is high. Appropriate patient selection, adequate training, use of prefilled injection devices and counseling regarding bleeding patterns are likely to maximize success rates with self-administration. By improving the convenience of this contraceptive method, self-injection might improve both compliance and continuation rates. The potential for self-administration of this contraceptive deserves formal study.