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Depo Provera

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41. Hormonal Contraceptives

2: Non-oral contraceptives for pharmacist prescribing Brand Name Components (EE – Ethinyl estradiol) Progestin Only Depo-Provera® Depo-Medroxyprogesterone Acetate 150mg IM Combination Nuvaring® EE 15mcg and etonogestrel 120mcg released daily Evra® EE 35mcg and norelgestromin 200mcg released daily Fee pseudoDIN 00951104; maximum of 1 claim per year Prescribe 1 or 2 months of therapy initially (3 months if using Seasonale, Seasonique or Depo-Provera). Can provide refills up to one year (...) are not associated with an increased risk of thromboembolism. 1) Non-prescription contraceptive options Failure rates with typical use over a year Male condoms (11-16%) Diaphragm (15%) Sponge (16-30%) Female condoms (20%) Spermicide alone (30%) Condoms provide protection against STIs 2) Prescription options Patients should be counselled about the advantages and disadvantages of long-acting reversible contraceptives (copper IUD, levonorgestrel-eluting IUDs, depo-medroxyprogresterone injection). If a long-acting

2018 medSask

42. Selected practice recommendations for contraceptive use

57 Combined pill and progestin-only pill 9 0.3 67 Evra patch 9 0.3 67 NuvaRing® 9 0.3 67 Depo-Provera 6 0.2 56 Intrauterine contraceptives ParaGard® (copper T) 0.8 0.6 78 Mirena® (levonorgestrel) 0.2 0.2 80 Implanon® 0.05 0.05 84 Female sterilization 0.5 0.5 100 Male sterilization 0.15 0.10 100 Emergency contraceptives: Emergency contraceptive pills or insertion of a copper intrauterine contraceptive after unprotected intercourse substantially reduces the risk of pregnancy. i Lactational (...) ; estimates for fertility awareness-based methods, withdrawal, the male condom, the pill and Depo-Provera are taken from the 1995 and 2002 National Survey of Family Growth corrected for underreporting of abortion. b Among couples who initiate use of a method (not necessarily for the first time) and who use it perfectly (both consistently and correctly), the percentage who experience an accidental pregnancy during the first year if they do not stop use for any other reason. c Among couples attempting

2017 World Health Organisation Guidelines

43. What can be done to help heavy periods?

and medroxyprogesterone acetate are taken on a cyclical basis. They can be effective at reducing blood loss and at helping to regulate the menstrual cycle. Long term they are often unacceptable because of their side effects such as bloating, headache, breast tenderness and breakthrough bleeding. The contraceptive injection (eg Depo-Provera) may stop periods altogether but it is not licensed as a treatment for menorrhagia. The combined oral contraceptive pill can often diminish menstrual loss although there is little

2016 Evidently Cochrane

44. American Association of Clinical Endocrinologists and American College of Endocrinology Clinical Practice Guidelines for the Diagnosis and Treatment of Postmenopausal Osteoporosis

Type 2 Growth hormone deficiency Hypercortisolism Hyperparathyroidism Hyperthyroidism Hypogonadism Hypophosphatasia Porphyria Pregnancy Alcoholism Anorexia nervosa Calcium deficiency Chronic liver disease Malabsorption syndromes/ malnutrition (including celiac disease, cystic fibrosis, Crohn’s disease, and gastric resection or bypass) Total parenteral nutrition Vitamin D deficiency Antiepileptic drugs a Aromatase inhibitors Chemotherapy/ immunosuppressants Depo-Provera Glucocorticoids Gonadotropin

2016 American Association of Clinical Endocrinologists

46. Contraception - progestogen-only methods

causes changes in cervical mucus that inhibit sperm. When used perfectly (consistently and correctly), 0.05% of women will conceive within the first year of use due to method failure. The progestogen-only injectables contain depot medroxyprogesterone acetate (Depo Provera® and Sayana Press®) or norethisterone enantate (Noristerat®). Depo Provera® should be given by deep intramuscular injection every 12 weeks. Sayana Press® should be given by subcutaneous injection every 13 weeks. Noristerat® should

2019 NICE Clinical Knowledge Summaries

47. Mobile phone-based interventions for improving contraception use. (PubMed)

an intervention comprising automated interactive voice messages and phone counsellor support (RR 1.39, 95% CI 1.17 to 1.66).One feasibility trial in the USA reported a lower mean number of days between scheduled and completed attendance for the first but not subsequent Depo-Provera appointments using clinic records from an intervention comprising reminders and healthy self management text messages (mean difference (MD) -8.60 days, 95% CI -16.74 to -0.46). Simple text message OC reminders had no effect

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2015 Cochrane

48. Postpartum family planning

) Breastfeeding women Male and female condoms Progestogen-only injectable (POI) contraceptives (Depo-Provera/NET-EN) Progestogen-only pills (POP) Male sterilisation Female sterilisation Contraceptive implants 6 months 12 months and beyond All women IUD 48 hours 4 days 7 days 3 weeks 4 weeks 6 weeksBest practice in postpartum family planning 5 Royal College of Obstetricians and Gynaecologists Best Practice Paper No. 1 The most effective methods These methods are generally associated with failure rates of less (...) users. Progestogen-only injectable (POI) contraceptives • Progestogen-only injectable (POI) contraceptives (Depo-Provera ® and norethisterone enanthate (NET-EN)) last 8–12 weeks and so repeat injections must be given four or more times each year, requiring the woman to return to a provider or be in contact with a community-based distributor. • Failure rates are around 3 per 100 users largely because of failure to get a repeat injection. • Amenorrhoea is common with these methods and the return

2015 Royal College of Obstetricians and Gynaecologists

49. Breast cancer - managing FH

on . Etonogestrel-only implant (Nexplanon ® ). For more information, see the CKS topic on . Depot medroxyprogesterone acetate (Depo-Provera ® , SAYANA PRESS ® ). For more information, see the CKS topic on . Progestogen-only pill (POP). For more information, see the CKS topic on . Combined hormonal contraceptives (CHC). For more information, see the CKS topic on . Inform women aged over 35 years with a family history of breast cancer that there is an increased risk of breast cancer associated with taking (...) be generally used (UKMEC category 2): POP. Depot medroxyprogesterone acetate (Depot-Provera ® , SAYANA PRESS ® ). Etonogestrel-only implant (Nexplanon ® ). LNG-IUS. If the CHC is being considered (UKMEC category 3), discuss with (or refer the woman to) a specialist genetics service, as views are conflicting on whether or not the protective effects of CHC against ovarian cancer outweigh the increased risk of breast cancer. Basis for recommendation Basis for recommendation These recommendations are based

2018 NICE Clinical Knowledge Summaries

50. Dysmenorrhoea

to an NSAID if the response is insufficient. See the CKS topic on for information on prescribing paracetamol. If the woman does not wish to conceive, consider prescribing a 3–6 month trial of a hormonal contraceptive as an alternative first-line treatment. Monophasic combined oral contraceptive (COC) preparations containing 30–35 micrograms of ethinylestradiol and norethisterone, norgestimate, or levonorgestrel are usually first choice. Oral (desogestrel 75 micrograms), parenteral (Depo-Provera ®

2018 NICE Clinical Knowledge Summaries

51. Contraception During Breastfeeding

: progestin-only options There is theoretical concern related to milk supply when progesteroneoptionsareinitiatedintheinitial48hoursafter delivery 24 as a drop in progesterone levels after birth is necessary for secretory differentiation/lactogenesis II to occur. Progestin-containing contraceptives include the progestogen-only pill (‘‘minipill’’) as well as contraceptive implants such as Nexplanon (Merck & Co.), Depo- Provera (depot medroxyprogesterone acetate [DMPA]; P?zer,NewYork,NY (...) postpartum period is contradictory and insuf?cient. COC, combined oral contraceptive; DMPA, depo-medroxyprogesterone acetate; IUD, intrauterine device; LNG, levonorgestrel. 5 hormonalmonitoring,andthencouplesabstainduringfertile periods. All of these methods have speci?c protocols for womentouseduringthepostpartumperiodsotheymayplan accordingly if they wish to delay another pregnancy. The Marquette model has a recent peer-reviewed study to show the ef?cacy of its postpartum protocol. 18 These methods may

2015 Academy of Breastfeeding Medicine

53. St Johns Wort and Hormonal Contraception

-druginteractions.org St John’s Wort and Hormonal Contraception 2014 Reference List (1) Faculty of Sexual & Reproductive Health Care. Drug Interactions with Hormonal Contraception. http://www.fsrh.org/pdfs/CEUGuidanceDrugInteractionsHormonal.pdf. 2011. (2) Pfizer Limited. Sayana Press:Summary of Product Characteristics. 2013. http://www.medicines.org.uk/emc/medicine/27798/SPC/SAYANA+PRESS+1 04+mg+0.65+ml+suspension+for+injection (3) Pfizer Limited. Depo-Provera 150mg / ml injection. 2012. http (...) ://www.medicines.org.uk/emc/medicine/11121/SPC/Depo- Provera+150mg+ml+Injection/ (accessed 19/03/14) (4) Watts DH, Park JG, Cohn SE, Yu SHJ, Stek A, Clax PA, et al. Safety and Tolerability of DMPA among HIV infected women on antireteroviral therapy. Contrcaeption 2008;72((2)):84-90. (5) Nanda K, Amaral E, Hays M, Viscola MAM, Mehta N, Bahamondes L. Pharmacokinetic interactions between depot medroxyprogesterone acetate and combination antiretroviral therapy. Fertility and Sterility 2008;90(4):965-71.

2014 Faculty of Sexual & Reproductive Healthcare

54. Progestogen-only Injectable contraception

Effectiveness Unit This guidance provides evidence-based recommendations and good practice points for health professionals on the use of progestogen-only injectables (depot medroxyprogesterone acetate (DMPA), Depo-Provera) currently available in the UK. It is intended for any health care professional or health service providing contraception or conception advice in the UK. Your download should start automatically. If not . Document types Thinking about taking a qualification? Registration is now quick

2014 Faculty of Sexual & Reproductive Healthcare

56. Depot Medroxyprogesterone Acetate and Bone Effects

medroxyprogesterone acetate (Depo-Provera) effects on bone health in adolescents: study design, population characteristics and baseline bone mineral density. Contraception 2008;77:239–48. Harel Z, Johnson CC, Gold MA, Cromer B, Peterson E, Burkman R, et al. Recovery of bone mineral density in adolescents following the use of depot medroxyprogesterone acetate contraceptive injections. Contraception 2010;81:281–91. Kaunitz AM, Arias R, McClung M. Bone density recovery after depot medroxyprogesterone acetate (...) . The effects of depot medroxyprogesterone acetate and intrauterine device use on fracture risk in Danish women. Contraception 2008;78:459–64. Pfizer Inc. Depo-provera CI (medroxyprogesterone acetate) injectable suspension, for intramuscular use: highlights of prescribing information. New York (NY): Pfizer; 2012. Available at: . Retrieved February 12, 2014. Hatcher RA, Trussell J, Nelson AL, Cates WJ, Kowal D, Policar MS. Contraceptive technology. 20th ed. New York (NY): Ardent Media; 2012. Cundy T, Ames R

2014 American College of Obstetricians and Gynecologists

57. Antigone (desogestrel) - Contraception

and its generics and 3 hours for MICROVAL. HAS - Medical, Economic and Public Health Assessment Division 6/12 6.1.2 Other progestogen contraceptives For information, progestogen contraceptives are used parenterally: NEXPLANON 68 mg, implant for subdermal use (etonogestrel): - indication: "Contraception. The safety and efficacy have been established in women between 18 and 40 years of age." - the implant may be left in place for 3 years, - reimbursable proprietary medicinal product. DEPO PROVERA

2014 Haute Autorite de sante

58. "It is my business": A Mixed-Methods Analysis of Covert Contraceptive Use among Women in Rakai, Uganda. (PubMed)

"It is my business": A Mixed-Methods Analysis of Covert Contraceptive Use among Women in Rakai, Uganda. Covert contraceptive use (CCU) is the use of family planning without a partner's knowledge. This study sought to examine CCU prevalence among women living in Rakai, Uganda, predictors of CCU, and why women resort to CCU.We used data from women (15-49years) currently using contraceptives (oral contraceptives, Depo Provera, implants, intrauterine devices, and periodic abstinence) during Round

2018 Contraception

59. Study of Daily Application of Nestorone® (NES) and Testosterone (T) Combination Gel for Male Contraception

contraception. If hormonal contraception has been used, the following applies: If recently used intramuscular Depo-Provera must have had last injection at least 3 months prior enrollment; If using an IUD or an implant, she is planning to have this removed for purposes unrelated to enrollment in the study prior to entering the efficacy phase; Completion of her last pack of oral contraceptives or completion of effectiveness period for a monthly injection, patch or ring if any has been used prior to entering

2018 Clinical Trials

60. A Study to Evaluate the Efficacy of the Investigational Products on Complete Spontaneous Bowel Movements in Participants Who Normally Have ≤ 3 Complete Spontaneous Bowel Movements Per Week But Are Otherwise Healthy

control and have a negative urine pregnancy test result. All birth control must have been in use for a minimum of three months and the participant must have one regular menstrual cycle in the last 30 days. Acceptable methods of birth control include: Hormonal contraceptives including oral contraceptives, hormone birth control patch (Ortho Evra), vaginal contraceptive ring (NuvaRing), injectable contraceptives (Depo-Provera, Lunelle), or hormone implant (Norplant System) Double-barrier method

2018 Clinical Trials

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