Medroxyprogesterone acetate [Depo Provera] injections. Development of striae.

ABSTRACT

PIP: This case report presents a 20-year-old woman with extensive striae while on Depo-Provera injections. She attended the family planning clinic requesting Depo-Provera injection because she was feeling nauseated while on the combined oral contraceptive pill. Following the first injection, striae developed and a weight gain of 3.1 kg was noted. At this point, the stretch marks were attributed to the weight gain and dietary advice was given. However, in her second dose of Depo-Provera, her striae had now become quite florid and were distributed on her abdomen, upper arms, thighs, buttocks, back, and legs. Moreover, her weight had increased by a further 2.6 kg; no other symptoms were reported. Following her dietary discussion, she decided to switch to a progesterone-only pill. On her next visit the following month, she was continuing to gain weight. Endocrine investigations were negative; hence, the development of striae was attributed to her weight gain. A search through Pharmacia and Upjohn, manufacturers of the contraceptive injection, showed very few reported cases of striae following Depo-Provera injection. Furthermore, for most cases no opinions were provided as to the cause, and the outcome of events was not reported or was not known.