Depo-provera

General Information

Depo-Provera (Depot Medroxyprogesterone Acetate) is an injectable contraceptive that contains a synthetic hormone similar to the hormone progesterone that is produced naturally by your body. Progesterone helps regulate the menstrual cycle and is produced only after an egg is released from the ovaries. Depo-Provera prevents pregnancy by creating the illusion that your body has already released an egg so another egg won't be produced. If an egg is not released, sperm cannot fertilize it. The drug also causes changes in the uterine lining to make it less likely for implantation to occur.

The injection protects against pregnancy for three months at a time. It is 99.7% effective, making it one of the most reliable methods of birth control available. It is important to return to the clinic every three months for follow-up shots. If you're more than two weeks late for the follow-up shot, you may not be protected against pregnancy and will be required to have a pregnancy test before the next shot.

Depo-Provera is given as an injection in the buttock or upper arm every three moths. The first injection should be given within the first five days of a normal menstrual period, within five days after childbirth for non-breastfeeding women, or six weeks after childbirth for women who are breast-feeding. A pregnancy test, recent physical exam and Pap test should be done prior to receiving the first injection. Because even the most sensitive test can't detect pregnancy in the first two weeks, it is important to abstain from sex or only have protected sex two weeks before the first injection.

The most common side effects include irregular menstrual bleeding, amenorrhea, weight gain, headache, nervousness, stomach pain or cramps, dizziness, weakness or fatigue, and decreased sex drive.

Specific Concerns:
During the first year of use, 30-50% of women using Depo-Provera do not have their periods. By the end of the second year, 70%, and by the end of the fifth year, 80%. Initially you may just have slight spotting. If injections have been received regularly every three months, lack of a period does not mean you are pregnant. Once the drug is discontinued periods usually return within 3-10 months after the last injection.

Use of Depo-Provera Contraceptive Injection may cause you to lose calcium that is stored in your bones. The longer you use this method the more calcium you're likely to lose. The calcium may not return completely once you stop using Depo-Provera.

Studies indicate that women who use Depo-Provera are not at increased risk for cancer of the breast, cervix, ovary, or liver and are protected against endometrial cancer. There may be a slightly increased risk of breast cancer in women under 35 years old whose first exposure to the drug was within the previous four years.

Depo-Provera is not a good choice if you want to become pregnant in the next year or two. Half of women become pregnant after 10 months of discontinuing use, two-thirds after 12 months, 83% after 15 months, and 93% become pregnant after 18 months.

This product does not protect against HIV infection and other sexually transmitted infections.

Absolute Contraindication:

Depo-Provera should not be used when pregnant, with vaginal bleeding of unknown cause, cancer of breast or reproduction organs, history of stroke, history of phlebitis (blood clots) in legs, history of liver disease, or if allergic to Depo-Provera or any of its ingredients.

CALL IMMEDIATELY IF any of the following occur after an injection of Depo-Provera:

Sharp chest pain, coughing of blood, or sudden shortness of breath.
Sudden severe headache or vomiting, dizziness or fainting, problem with eyesight or speech, weakness or numbness in an extremity.
Severe calf pain or swelling.
Unusually heavy vaginal bleeding.
Severe pain or tenderness in the lower abdominal area.
Persistent pain, pus, or bleeding at the injection site.