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Depo-Provera

Depo-Provera Contraceptive Injection (medroxyprogesterone acetate) is the U.S. brand name of a birth control product manufactured by Pfizer Inc. It is a hormonal birth control method containing a synthetic progestin, without estrogen, and is administered to women in the form of an intramuscular injection once every 11 to 13 weeks. Depo-Provera causes the ovaries to stop releasing eggs, and is 99.7% effective at preventing pregnancy. more...

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Benefits

  • Unlike oral contraceptive pills which have to be taken at roughly the same time each day (Combined Oral Contraceptive Pill within 12 hours and Progesterone only pill within 3 hours), the effectiveness is not dependent upon the ability to remember to take daily doses. The only continuing action is to book subsequent follow-up injections every twelve weeks.
  • Likewise, Depo Provera is not affected by absorption issues (diarrhoea, vomiting, bowel disorders) nor by antibiotic effects on the normal gut bacterial flora.
  • One side effect (and to some a benefit) is that many women stop having a regular menstrual cycle while on the drug.
  • It provides hormonal birth control without the risks associated with estrogen and may in fact reduce the risk of ovarian and endometrial cancers.
  • Depo Provera, like progestin-only pills, may be used by breast-feeding mothers; this is not the case for combined oral contraceptive pill. Heavy bleeding is possible if given in the immediate postpartum time and is best delayed until six weeks after birth. It may be used within five days if not breast feeding.

Disadvantages & side effects

  • The commonest reason for people not choosing this method of contraception is hypodermic needle phobia.
  • Recent research has shown that Depo-Provera significantly decreases bone density in women, as compared with others in the same age group (see below).
  • For some women, Depo-Provera may have a number of potentially intolerable side effects, including loss of interest in sexual activity, infertility, severe headaches, constant bleeding, weight gain, panic attacks, muscle pain, heart palpitations, pain during sex, and acne. Side effects of Depo-Provera may persist up to 24 months after the last injection.
  • Those planning a pregnancy after having used Depo-Provera may wish to switch to alternative contraceptive methods some 6-9 months prior. Whilst it only gives consistent contraception for 12 weeks, and pregnancy is possible after 13 weeks if not repeated in time, fertility may be temporarily reduced in some women for up to 24 months with average fertility returning in approximately 9 months.
  • Depo-Provera is also used with male sex offenders as a form of chemical castration as it has the effect of drastically reducing sex drive in males.
  • A study of 819 women in one city found an association between using Depo-Provera and higher incidence of chlamydia and gonorrhea. See Hormonal contraceptive use, cervical ectopy, and the acquisition of cervical infections by C. S. Morrison, P. Bright, E. L. Wong, C. Kwok, I. Yacobson, C. A. Gaydos, H. T. Tucker HT and P. D. Blumenthal in Sexually Transmitted Diseases (2004) Vol. 31 p. 561-567.

Read more at Wikipedia.org


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Bone loss related to Depo-Provera reverses after discontinuing therapy - Prospective Cohort Study
From OB/GYN News, 10/15/02 by Sharon Worcester

Bone loss associated with depot medroxyprogesterone acetate was reversible in a prospective population-based cohort study.

In 183 nonpregnant, reproductive-age users of the injectable contraceptive, which is sold as Depo-Provera, bone density at the spine changed at an annualized mean rate of -0.87%, compared with 0.40% in 274 nonusers. Bone density at the hip changed by -1.12% in users, compared with -0.05% in nonusers, reported. Delia Scholes, Ph.D., and her colleagues at the University of Washington, Seattle.

But in 110 of the Depo-Provera users who discontinued the agent, sizable increases in bone density were noted. The estimated annualized mean change at the spine was 1.41% in those who stopped using Depo-Provera, compared with 1.03 in those who continued using it. At the hip, the estimated change was 0.40% in those who stopped use, compared with -0.05% in those who continued. At 30 months follow-up, bone density in those who stopped using Depo-Provera was similar to that of the control patients who had not used it (Epidemiology 13[5]:581-87, 2002).

COPYRIGHT 2002 International Medical News Group
COPYRIGHT 2002 Gale Group

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