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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 users appear to be prone to STDs: the use of oral contraceptives was not associated with increased risk or development of infections
From OB/GYN News, 10/1/04 by Heidi Splete

Use of Depo-Provera was significantly associated with the development of cervical infections in a study of 819 women, said Charles S. Morrison, Ph.D.

Even after adjustment for sexual behavior and demographic traits including condom use and multiple sex partners, women who used Depo-Provera (medroxyprogesterone) were more likely to developed gonorrhea or chlamydia within a year, compared both with women who used oral contraceptives and controls, said Dr. Morrison of Family Health International, a research organization in Research Triangle Park, N.C.

The use of oral contraceptives was not associated with increased risk or development of infections.

After a mean follow-up of 337 days, 45 women in the prospective cohort study had developed at least one cervical infection.

Most of the women were single (77%) and nulliparous (75%). They ranged in age from 15 to 45 years, with a median age of 22 years (Sex. Transm. Dis. 31[9]:561-67, 2004).

The researchers calculated risk based on how many women became infected within a year (woman-years) and found a rate of 13.7 infections/100 woman-years in the Depo-Provera group, significantly higher than women in the oral contraceptive group (3.9 infections/100 woman-years) and the control group (6/100 woman-years).

More research is needed to determine whether Depo-Provera itself creates a susceptibility to infection.

Meanwhile, women taking Depo-Provera can reduce their risk of infection by using additional protection if they are in nonmonogamous relationships.

"All of the labeling and educational material for Depo-Provera includes information about how it doesn't protect women from sexually transmitted diseases," according to Rebecca Hamm, who is a spokesperson for Pfizer, which markets Depo-Provera.

The study seems to reinforce the need for women using hormonal contraception to receive not only those materials, but also additional reminders from their physicians about the need to protect themselves if they are at increased risk for STDs, she commented in an interview with this newspaper.

BY HEIDI SPLETE

Senior Writer

COPYRIGHT 2004 International Medical News Group
COPYRIGHT 2004 Gale Group

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