DEPO PROVERA

Depo-Provera

Depo Provera (also known as DMPA or Depot Medroxyprogesterone Acetate) is a hormone injection that lasts for 3 months to prevent pregnancy. The injection contains synthetic progesterone and no estrogen. It is usually given in the the arm, hip, upper thigh, or abdomen, delivering a high level of progesterone into the body. Depo Provera stops the ovaries from releasing eggs. Depo Provera causes the cervical mucus to thicken and changes the uterine lining, making it harder for sperm to enter or survive in the uterus. These changes prevent fertilization. Depo Provera is a very private form of birth control because it cannot be seen on the body and requires no home supplies. It does, however, require a clinic appointment every 3 months.

Depo Provera is 97-99.7% effective as birth control. It does not protect against reproductive tract infections, including HIV/AIDS. There are some serious health risks with Depo Provera, so be sure to get all the facts in advance.

Use

The first shot of Depo Provera is usually given during or a few days after the start of a menstrual period. After 24 hours, the shot is effective birth control for the next 13 weeks. Many women find it useful to schedule their next shot slightly earlier than necessary; if something prevents them from making their appointment, there will be a window of opportunity to receive their next shot.

If you are more than a week late for your shot, use a backup method of birth control for the next two weeks. If you are more than a week late and you have had unprotected sex since your last shot, consider taking a pregnancy test before receiving the next dose.

Your Health       

Due to the risk of serious health problems, women with the following conditions should not use Depo Provera.

    * Unexplained vaginal bleeding

    * Known or suspected pregnancy

Depo Provera may not be recommended for women who are planning on becoming pregnant in the near future, are concerned about weight gain, have liver disease, gallbladder disease, or a history of depression. Study the risks and talk with your health care practitioner.

Health Risks:

Studies released in 2004 show that Depo Provera is associated with a loss of bone density resulting in an increased risk of osteoporosis. The bone loss appears not to be reversed when the woman goes off Depo Provera. Depo is not recommended for long term use and especially not recommended when the young woman is still growing her bones. Women on Depo are advised to exercise and take in plenty of calcium. If you have taken Depo Provera for more than two years, you might want to get a bone density test. (see article on Building Healthy Bones and factsheet on calcium-containing foods )

    Some women have allergic reactions to Depo Provera.

 If a woman becomes pregnant while using Depo Provera, and continues her pregnancy, there may be an increased risk of premature birth.

The effects of Depo Provera on breast cancer are still unknown.

Halth Benefits:

Women on Depo Provera have a decreased risk of endometrial cancer, ovarian cancer, and pelvic inflammatory disease. You may have less menstrual cramping and pain, fewer periods, and less chance of anemia.

Side Effects       

70% of women using Depo Provera gain weight. Almost half of the women using Depo Provera gain more than 5 pounds after one year of use. Many women gain more than 10 pounds.

Irregular, heavy, or no bleeding are common side effects of Depo Provera. After a year of use, many women stop having periods. Lack of a period becomes increasingly common with longer use.

Other side effects of Depo Provera can include headaches, nervousness, mood changes, bloating, hot flashes, decreased interest in sex, breast tenderness, acne, hair loss, and back ache.

After the last shot of Depo Provera, it can take over 6 months for the drug to leave the body. Side effects may linger until the drug is completely gone.

Drug Interactions            

Few medications lower the effectiveness of Depo Provera. Women with Cushing's syndrome may take medications that interfere with Depo Provera. If you are taking any medications, tell your clinician. When taking medications that may interfere with Depo Provera, consider adding a backup method of birth control, like condoms or spermicide. As with all drugs, it is useful to inform all your medical providers if you are taking Depo Provera.

Advantages       

    * Private.

    * Effective after 24 hours.

    * Does not require regular attention.

    * Does not interrupt sex play.

    * Has no estrogen.

    * May decrease risk for ovarian and uterine cancers.

    * Women can start Depo Provera 6 weeks after giving birth.

Disadvantages

    * Causes loss of bone density and risk of osteoporosis.

    * Does not protect against sexually transmitted infections, including HIV/AIDS.

    * Requires injections every 3 months.

    * Delay of return to fertility.

    * Irregular bleeding.

    * Most women experience weight gain [study of link between Depo Provera and weight gain: Women using depot medroxyprogesterone acetate (DMPA), commonly known as the birth control shot, gained an average of 11 pounds and increased their body fat by 3.4 percent over three years, according to researchers at the University of Texas Medical Branch (UTMB).]

Future Fertility

Women who want to become pregnant may stop using Depo Provera at any time. For some women, fertility returns immediately. For others, it may take 6-18 months or longer for the body's hormone cycle to go back to normal.

Going Off Depo

The book Contraceptive Technology says: "It is not possible to discontinue Depo Provera immediately. Weight gain, depression, breast tenderness, allergic reactions, and menstrual irregularities may continue until Depo Provera is cleared from a woman's body, about 6 to 8 months after her last injection. After discontinuing Depo Provera, women may also have a 6 to 12 month delay in return of fertility."

You might try cleansing techniques to detox or eliminate the synthetic hormone from where it is stored in your body's tissues: drink lots of water every day, eat lots of fresh raw organic vegetables, drink raw vegetable juice, sweat in a steam room or sauna, get lots of exercise and fresh air. You can also ask at a health food store about herbal formulas or teas that help detoxify your body or that balance female hormones, or talk with a naturopathic physician or herbalist.

IF you decide to switch from Depo Provera to another hormonal method like the birth control pill, the vaginal ring, or the contraceptive patch, it is recommended that you start your new method on the date the next injection is due. Use a back-up method of contraception such as male condoms, female condoms, or abstinence for the first seven days of pill use.

Prevent Coercion           

There is no antidote to the Depo Provera shot. Women who are given Depo Provera should be well informed about the drug and know that there are other options for birth control. In this country and in other countries, women have been pressured into taking Depo Provera without knowing what it was. Know your options.

urther References

     * Depo Diaries - learn more by reading women's stories of their experiences. Or share your own story about your Depo experience? Click here and share your story.

    * New Black Box Warnings about Depo Provera Shots

          o http://www.docguide.com/news/content.nsf/news/8525697700573E1885256F5100513452

          o http://my.webmd.com/content/article/97/104089.htm

    * Women using depot medroxyprogesterone acetate (DMPA), commonly known as the birth control shot, gained an average of 11 pounds and increased their body fat by 3.4 percent over three years, according to researchers at the University of Texas Medical Branch (UTMB).

    * calcium-containing foods - for maintaining bone strength, good article on Building Healthy Bones

    * Safer Sex Info

    * Symptoms and treatments for Reproductive Tract Infections and STIs

    * Coalition for Positive Sexuality

    * Our Bodies, Ourselves from Boston Women's Health Collective, new version in 2005

    * Reproductive Health Technologies info about Depo Provera

    * PDF of this page