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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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Depo-Provera tied to increased heart disease risk in small study - Maker Points to 'Well-Proven' Safety Profile
From OB/GYN News, 10/1/02 by Sharon Worcester

Chronic use of depot medroxyprogesterone acetate may have an adverse effect on cardiovascular health, a small, nonrandomized study suggests.

The widely used, long-acting contraceptive sold as Depo-Provera and given as a 150-mg injection every 12 weeks inhibits ovarian follicle proliferation. This causes anovulation and decreased circulating estrogen, which could lead to reduced arterial function and increased risk of cardiovascular disease, Morten B. Sorenson, Ph.D., of Royal Brompton Hospital, London, and his colleagues reported (Circulation; available at http://circ.ahajournals.org/rapidaccess.shtml; published online Sept. 3, 2002).

While the investigators concluded that the "prevailing recommendation to use [Depo-Provera] in women with cardiovascular disease" should be further evaluated, Pharmacia, the drug's maker, is emphasizing its "well-proven" safety profile.

"There is no increased risk of cardiovascular disease noted in large-scale clinical or epidemiological trials with Depo-Provera," Dr. Joel Krasnow, medical director of women's healthcare for Pharmacia, Peapack, N.J., said in a statement issued-by the company.

The drug has been used safely by millions of women for more than 30 years, but healthcare professionals should always carefully consider the use of any medication, including Depo-Provera, before prescribing, particularly for women with preexisting cardiac risk factors, Dr. Krasnow said.

The study included 13 amenorrheic Depo-Provera users and 10 controls with regular menstrual cycles. Cardiovascular magnetic resonance was used to measure changes in the brachial artery area. Hyperemia-induced flow-mediated dilatation, which is an endothelium-dependent indicator of vascular reactivity, was significantly reduced in the Depo-Provera group (to 1.1%), compared with controls (to 8.0%) during menstruation. There were no differences in levels of glyceryl trinitrate, an endothelium-independent indicator of vascular reactivity.

S-estradiol levels, however, were found to be significantly lower in the Depo-Provera patients--who had been using the drug and been amenorrheic for at least 1 year--than in controls during menstruation (58 vs. 96 pmol/L). The estradiol levels were significantly correlated to flow-mediated dilatation.

COPYRIGHT 2002 International Medical News Group
COPYRIGHT 2002 Gale Group

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