What is Depo Provera?
Depo Provera is a hormone injection that lasts for 3 months to prevent pregnancy. The injection has synthetic progesterone and no estrogen. It is usually given in the arm or rear, delivering a high level of progesterone into the body. Depo Provera stops the ovaries from releasing eggs. It thickens the cervical mucus 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 sexually transmitted infections, including HIV/AIDS.
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, such as emergency contraception 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.
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.
Studies released in 2004 show that Depo Provera is associated with the lost of bone density resulting in an increased risk of osteoporosis. The bone loss appears to be reversed when the woman goes off Depo Provera. Women on Depo are advised to exercise and take in plenty of calcium and Vitamin D. Some women have allergic reactions to Depo Provera.
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.
Seventy percent of women who use 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.
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.
- 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 3 weeks after giving birth.
- May cause 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.
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 Provera
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. 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.
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.
Contraception and Sex Information You Can Actually Use: www.io.com/~wwwomen/contraception/
Our Bodies, Ourselves, Boston Women’s Health Book Collective, www.ourbodiesourselves.org
Feminist Women’s Health Center at www.feministcenter.org 404-728-7900