Depo-Provera is a contraceptive given to women in the form of a shot once every three months.
Doctors and fertility specialists agree it's an extremely effective form of birth control, but is it too effective? And are women being properly educated about all the possible effects especially when it comes to future fertility?
Fertility
A viewer e-mailed FOX21 News concerned about her inability to get pregnant after receiving the Depo Provera birth control shot for several years. She struggled with other contraceptive methods before finding Depo-Provera, which worked until she wanted to have more children.
She has been off the shot for a year and has had no luck getting pregnant, but what's worse is she said her doctor never told her about how long it can take once you stop the shot for ovulation to return to normal.
The patient product labeling for Depo-Provera discloses that because "Depo-ProveraContraceptive Injection is a long-acting birth control method, it takes some time after your last injection for its effect to wear off. Based on the results from a large study done in the United States, of those women who stop using Depo-Provera Contraceptive Injection in order to become pregnant, about half of those who become pregnant do so in about 10 months after their last injection; about two-thirds of those who become pregnant do so in about 12 months, about 83 percent of those who become pregnant do so in about 15 months, and about 93 percent of those who become pregnant do so in about 18 months after their last injection."
Dr. Shona Murray, fertility specialist at ADVANCE REPRODUCTIVE MAGAZINE said while Depo-Provera can't make a woman infertile, it can mask other fertility problems. "There are other reasons for having irregular cycles that might get missed because it's being put down as just being on Depo-Provera."
Age is one important factor Murray said to consider.
Age is probably the most important thing from a woman's fertility point of view. As early as age 30 we start seeing a slight decrease in fertility. And for someone in their late thirties and then comes off Depo-Provera and having problems with periods, they probably want to come in and get help," said Murray.
Meredith Cassidy, M.D. of Academy Women’s Health reminds that "there is no perfect birth control that fits for everyone." Cassidy said she's seen some patients who have had virtually no wait time getting pregnant after stopping the shot. "There is a woman I'm thinking of who conceived within a week or two of a missed injection."
Bone Density
Murray said in the last five years she has seen fewer women using Depo-Provera. She believes the decrease is a result of the FDA Black Box Warning that prolonged use of more than two years can result in thinning of the bones.
However Cassidy argues now some studies do show that the bone loss is reversible and fairly rapidly reversible.
Who Is It Right & Wrong For?
According to the Depo-Provera website "You should not use Depo-Provera Contraceptive Injection if you have any of the following conditions: if you think you might be pregnant, if you have any vaginal bleeding without a known reason, if you have had cancer of the breast, if you have had a stroke, if you have or have had blood clots (phlebitis) in your legs, if you have problems with your liver or liver disease, or if you are allergic to Depo-Provera Contraceptive Injection (medroxyprogesterone acetate or any of its other ingredients)."
Additionally Murray added anyone "with a history of depression, people who don't do well with irregular bleeding, certainly someone thinking about getting pregnant in the next year or so," should try to stay away from Depo, if possible.
Who is the shot good for?
Women who other forms of birth control haven't worked for, those who are deciding whether they want permanent sterilization.
Things To Consider
If you end up having negative side effects the patient can't just stop taking a pill or wearing a patch. "You're stuck with it for several months until it's out of your system," explained Murray.
One woman who works in the medical field said she was warned about how long it can take to get pregnant, but what she didn't realize was how emotional it would be trying and waiting.
"Any form of contraceptives or sterilization when people's reproductive wishes change there's very often regret," said Murray.
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