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Depo-Provera

What is it?

Depo-Provera is an effective, long-acting, reversible method of birth control.  It is an injection (shot) given every 12 weeks under a clinician’s supervision.  The injection contains medroxyprogesterone acetate, a progestin hormone that prevents pregnancy.

How does it work?

Depo-Provera temporarily stops ovulation.  It also causes changes in the cervical mucus, preventing sperm from entering the uterus.

How effective is it?

It is rated 97-99% effective in preventing pregnancy.  It is more effective than many other birth control methods, including the pill.

How is it used?

Depo-Provera is given as an injection once every 12 weeks.  The first shot must be given within 5 days after the beginning of a period.  It starts working within 24 hours.  It slowly wears off over time and you cannot count on being protected against pregnancy after 12 weeks from the last shot.  Therefore, if you want to continue to use Depo-Provera, you must return for another shot every 12 weeks.

What are the possible side effects?

Side effects vary among women.  Usually, the side effects are not serious.  However, it is important to realize that once Depo-Provera is injected, it cannot be neutralized or reversed.  Therefore, you may have to live with the side effects until they wear off (as long as 6-8 months).

  • Menstrual changes: All women who use Depo-Provera notice changes in their menstrual periods.  During the first year of use, menstrual periods are usually irregular and spotty bleeding may occur between periods.  Some women also notice heavier or longer bleeding during their periods, but this rarely causes serious medical problems.  After 6-12 months of using Depo-Provera, most women have periods less often and may stop having periods altogether.  This change is not permanent, and periods will return after Depo is discontinued.
  • Other symptoms: Other side effects occur in many women after the first few injections, but then usually will go away.  Some women notice sore breasts, nausea, fatigue, abdominal discomfort, weakness, dizziness, or nervousness.
  • Weight changes: One of the effects of the hormone is an increased appetite.  About two-thirds of women gain about 5 pounds during the first year of use.  You can avoid weight gain by eating a healthy diet and exercising regularly.
  • Bones: There is a loss of bone density when using Depo. Bone density decreases during use, but research shows that once Depo is discontinued, bones begin to regain calcium and bone density can return to its original levels.

What else do I need to know?

  • Use a back-up method: You must use a back-up method of birth control (such as condoms) for 7 days after getting your first Depo injection.
  • Delay in return to fertility: After stopping use of Depo-Provera, it takes an average of 12 months from the last shot before you can become pregnant. Women who want to become pregnant in the near future should keep this in mind when deciding whether to use Depo-Provera.
  • Breast Milk: Depo-Provera is found in breast milk.  Nursing mothers as early as 6 weeks after delivery can use it, as it does not affect the amount or quality of milk.  However, it can show up in tiny amounts in the milk of nursing mothers.  No negative effects on the infant are known at this time.
  • Sexually Transmitted Infections: Depo-Provera does NOT provide any protection from sexually transmitted infections like chlamydia, gonorrhea, herpes, or HIV.  Using a latex condom every time you have sex can protect you against these infections.

What are the benefits of depo?

  • Depo-Provera is a convenient, effective, private, and reversible method of birth control.
  • Decreased anemia, menstrual cramps, and pain.
  • Little drug interactions with other medications.
  • Low risk of ectopic pregnancy.
  • Prevents cancer of the lining of the uterus.
  • Scanty or no periods.

Who cannot take depo-provera?

  • Women who are or suspect that they are pregnant.
  • Women with abnormal vaginal bleeding that have not yet been evaluated.
  • Women who are currently or have had a history of breast cancer.
  • Women who have liver problems
  • Women who have had a stroke, blood clots, or heart disease
  • Women who are allergic to Depo-Provera.

How do I get started?

  • Call (909) 869-4000 to make an appointment.
  • The first injection is given during the first 5 days of your period.
  • The cost at Student Health Services is $40 per injection.
  • Mark your calendar to return in 12 weeks.
  • Tell any health care provider you visit that you are using Depo-Provera.

Warning Signs

Serious health problems are very rare with Depo, however report any new or unusual medical problems to your clinician right away, especially:

  • prolonged, very heavy vaginal bleeding
  • unusual pain or swelling in the leg
  • severe chest pain
  • sudden shortness of breath or coughing up blood
  • very painful headaches or blurred vision
  • lump in your breast
  • depression
  • redness, pus, itching, bleeding and/or prolonged pain at the injection site
  • any other symptom that worries you

References

Hatcher, et. al., Contraceptive Technology, 20th Edition, 2011

World Health Organization, Family Planning – A global handbook for providers, 2011 Update

http://www.plannedparenthood.com

http://www.bedsider.org

http://www.pfizer.com/products