What is Depo-Provera?
Depo-Provera
is a long-acting progestin (hormone) form of birth control. It is
injected into the muscle every 11 weeks. It is effective 24 hours
after your first injection if given in the first 5 days of a normal
menstrual period. You will need to receive your injection promptly
every 11 weeks in order to continue your contraceptive protection.
How
does it work to prevent pregnancy?
It inhibits
the secretion of hormones that stimulate the ovaries. This prevents
ovulation. It also thickens your cervical mucus to prevent the entrance
of sperm into the uterus.
How
effective is Depo-Provera in preventing pregnancy and STIs?
With continuous
use, there is less than a 1% chance of experiencing an accidental
pregnancy. This rate assumes that no shots are missed. This rate
is also comparable to tubal ligation. However, Depo-Provera does
not offer any protection against STIs.
What
are some reasons to use Depo-Provera?
You
find it difficult to remember to take medicine every day.
You
are on long-term antibiotics or Accutane.
You
would be comfortable with having your menstrual periods stop (also
known as amenorrhea).
You
have valvular heart disease.
What
are some reasons NOT to use it?
Prolonged use may result in significant loss of bone density. The FDA suggests that Depo-Provera should only be used as a long-term birth control method (longer than 2 years) if other birth control methods are inadequate.
You
are pregnant or suspect you might be pregnant.
You
have abnormal vaginal bleeding that has not been evaluated.
You
have had a stroke.
You
have serious liver disease.
You
are being treated for or have a history of breast cancer.
You
have or have had blood clots in legs, lungs or eyes.
You
are allergic to Depo-Provera.
If you
have or have had
anorexia nervosa, migraine headaches, depression, heart disease,
high blood pressure, diabetes, liver disease, asthma or a seizure
problem, please tell your medical provider. Depo-Provera may make
these problems worse.
Since
it is unclear whether smoking while using Depo-Provera increases
the risks of heart attack and stroke, it is recommended that women
who use Depo-Provera should not smoke.
What
are the side effects?
The side
effects are usually not serious, but it is important to realize
that once Depo-Provera is injected, it cannot be reversed or neutralized.
You will have to live with the side effects until the medicine wears
off in 3 months.
Menstrual
irregularities
Bleeding, spotting and amenorrhea (not having periods) are common.
After a year of Depo-Provera injections, 57% of women are not menstruating.
After 2 years, 68% of women are not menstruating. If you stop getting
Depo-Provera injections, your period usually returns within 3 to
10 months.
Pregnancy-like
symptoms
These symptoms include sore breasts, nausea, fatigue, and abdominal
discomfort. They may occur after the first 4 injections but usually
go away. If you experience a spotty darkening of the skin (usually
on the face), this symptom may not go away completely.
Weight
changes
Weight changes may occur due to increased appetite. Average weight
gain is 3 pounds by the end of the 1st year and 5 to 7 pounds, total,
by the end of the 2nd year.
33.5%
of women on Depo-Provera gain weight
20%
of women on Depo-Provera lose weight
10%
of women on Depo-Provera have no change in their weight.
Depression
Depression may occur but the cause is unclear. It does go away if
you stop using Depo-Provera.
Other
symptoms
Other symptoms can include headache, dizziness, nervousness, some
loss of scalp hair, some increase in body hair, a decrease in sex
drive, leg cramps, and bloating. They may or may not be caused by
Depo-Provera. Report any of these side effects to your medical provider
immediately.
What
are other medical drawbacks and risks?
Delay
in ability to become pregnant
After the last injection of Depo-Provera, it takes an average of
9 to 12 months to become pregnant:
68%
of women conceive within 12 months.
83%
of women conceive within 15 months.
93%
of women conceive within 18 months.
These
rates are not related to the length of time you were taking Depo-Provera.
Cancer
One study found a slightly increased risk of breast cancer, especially
for women under age 35. There is no increased risk of ovarian, uterine,
cervical or liver cancer.
Osteoporosis
Use of Depo-Provera has been associated with a decrease in the amount
of calcium in your bones, which can increase your chance of bone
fractures. The rate of calcium loss is greatest in the early years
of use. Regular exercise, calcium in the diet or a calcium supplement,
and not smoking can help prevent osteoporosis in all women.
Sexually
transmitted infections
Depo-Provera does not protect you from sexually transmitted infections
(STIs). It is important to discuss STI protection with your partner
and to use a condom every time you have sex.
Call
your medical provider immediately if you experience any of the following:
Prolonged,
very heavy vaginal bleeding
Unusual
swelling or pain in the legs
Severe
chest pain, sudden shortness of breath or coughing up blood
Bad
headaches or blurred vision
A
lump in your breast
Persistent
pain, redness or bleeding at the injection site
Where can I get Depo-Provera
and how much does it cost?
Depo-Provera
is available at Health Services and costs $50 for each shot. You
can call 401.863-3953 to make an appointment with a medical provider
to discuss whether Depo-Provera is right for you.
Links you can use
To learn
more about Depo-Provera, you can visit:
Disclaimer: Health Education is part of Health Services at Brown University. Health Education maintains this site as a resource for Brown students. This site is not intended to replace consultation with your medical providers. No site can replace real conversation. Health Education offers no endorsement of and assumes no liability for the currency, accuracy, or availability of the information on the sites we link to or the care provided by the resources listed. Health Services staff are available to treat and give medical advice to Brown University students only. If you are not a Brown student, but are in need of medical assistance please call your own health care provider or in case of an emergency, dial 911. Please contact us if you have comments, questions or suggestions.
