Depo-Provera

What is Depo-Provera?

Depo-Provera is a shot for women that prevents pregnancy. It uses a man-made form of the female hormone progesterone. (Progesterone is one of the hormones used in birth control pills.) After a shot of Depo-Provera, the high level of progesterone in the body prevents the ovaries from releasing an egg for the next 3 months. If the ovaries do not release an egg, you cannot become pregnant. The hormone has 2 other effects that help prevent pregnancy. It changes the lining of the uterus, which helps prevent a fertilized egg from attaching to the uterus. And it thickens the mucus around the opening of the uterus (the cervix), making it hard for sperm to go into the womb. Fewer than 1% of women using Depo-Provera become pregnant.

How is it used?

Every 3 months your healthcare provider will give you a shot of Depo-Provera. The shot is usually given in a muscle of the upper arm or buttock during the first 5 days of your menstrual period.

The timing of the shot after you have had a baby depends on whether you are breast-feeding. If you are breast-feeding, you should wait until 6 weeks after the birth to get the shot. Use other forms of birth control, such as condoms or spermicides, during these 6 weeks.

If you are not breast-feeding, you should get your shot within 5 days after the birth.

What are the benefits?

Some of the benefits of Depo-Provera are:

• It is one of the most reliable forms of birth control.
• Protection against pregnancy starts 24 hours after the shot.
• There are no pills to take or devices to insert, and there is no interruption of sex.
• It can be used by women who are breast-feeding a child older than 6 weeks.
• Depo-Provera does not contain estrogen. It can be used by women who cannot take birth control pills because of the risk of cardiovascular problems from the estrogen in the pills.

Because eventually you may stop having menstrual periods while you are taking Depo-Provera, this method of birth control has other benefits, such as:

• You are less likely to become anemic from the loss of blood during your periods.
• You may no longer have a heavy menstrual flow or painful periods.
• You may stop having symptoms of premenstrual syndrome (PMS).

What are the disadvantages?

At first, the increased level of progesterone in your body may cause irregular menstrual bleeding or spotting. Gradually, if you keep getting the shots, you will stop having periods. When you stop getting the shots, your menstrual periods will start to return to normal.

If you decide to have a baby, it may take several months or longer to get pregnant after the last shot. Consider using Depo-Provera for birth control only if you know you don't want to get pregnant for at least a year.

Many women have no problems while using Depo-Provera. However, sometimes it causes side effects such as:

• weight gain
• headaches
• breast tenderness
• tiredness
• acne
• pain or swelling in your leg
• depression
• nausea
• trouble sleeping
• less interest in sex.

Other cautions associated with Depo-Provera are:

• This medicine may decrease the amount of calcium in your bones. This may increase your risk of osteoporosis and broken bones. Your provider may tell you take calcium and vitamin D to lessen the loss of calcium from your bones. If you need birth control for more than 2 years, your healthcare provider may suggest another birth control method or ask you to have bone density tests.
• Depo-Provera does not protect you against sexually transmitted diseases, such as AIDS. Latex or polyurethane condoms are the only safe way to protect against AIDS.
• If you have diabetes, Depo-Provera may cause a mild increase in your blood sugar. This may require a change in the amount of medicine you take for diabetes. Check with your healthcare provider about this.
• If you have a history of depression and are taking Depo-Provera, your provider will watch you closely for signs of depression. You may need to get help from a counselor and stop getting the shots if your depression recurs.

Who should not use Depo-Provera?

Some women with chronic diseases or other problems should not use Depo-Provera. For example, women who have had blood clots, certain cancers, heart attack, or stroke should not use it. Your healthcare provider will discuss your medical history with you.

This medicine may cause birth defects if given during the first 4 months of pregnancy. Do not take this medicine if you are pregnant. If you become pregnant, contact your healthcare provider right away.

When should I call my healthcare provider?

Call your provider right away if:

• You have an allergic reaction to the medicine (trouble breathing, tightness in the chest).
• You find that you were pregnant at the time of a shot or if you become pregnant within 3 months of a shot.
• You have side effects that continue or get worse.
• You want to change to a different birth control method.
• You have numbness or tingling.

Call during office hours if:

• You have itching, a skin rash, or redness.