Depo-Provera

Injection for Birth Control



Women who are looking for a long-term, highly effective method of birth control may want to use Depo-Provera, also known as DMPA or "the shot". Depo-Provera is a type of hormonal birth control that only needs to be administered four times a year.

Getting the Shot

Depo-Provera is a progestin injection that a doctor gives you every three months. Like the mini-pill and Norplant, this injection works to suppress ovulation, may thicken cervical mucus to create a hostile environment for sperm, and thins the uterine lining to make implantation of a fertilized egg difficult.

Each injection offers protection from pregnancy for 12 weeks. Because Depo-Provera can have detrimental effects on a fetus, you can only receive your first shot during the first five days of a normal menstrual cycle; during the first five days postpartum if you are not breastfeeding or after six weeks postpartum if you are breastfeeding. The injection is usually administered to the buttocks or the upper arm.

Many women prefer Depo-Provera because they do not have to worry about taking a pill every day. Women who are breastfeeding can use Depo-Provera but only after the sixth week postpartum. Additionally, Depo-Provera offers some protection against endometrial cancer. However, it offers no protection against sexually transmitted diseases.

Side Effects

Unlike the birth control pill, which provides women with a small dose of hormones on a daily basis, Depo-Provera gives women a large dose of progestin at one time. As a result, side effects of this type of contraceptive tend to be more pronounced.

One of the most common side effects of Depo-Provera is the absence of menstruation during the first year of use, which affects a quarter to half of all users. About 30% of users will continue to have regular periods (which suggests that ovulation is continuing) while the remainder of women on Depo-Provera are likely to experience irregular periods. Other side effects include:

Change in menstruation (may be lighter or heavier; shorter or longer)

Increase in spotting and breakthrough bleeding

Weight gain

Dizziness

Nervousness

Change in libido

Headaches

Rash or skin discoloration

Breast tenderness

Depression

Increase or decrease in facial and body hair

Hair loss

Unfortunately, little can be done about these side effects until the hormones from the shot wear off, which can take up to 14 weeks. It is also interesting to note that, because Depo-Provera tends to suppress the production of testosterone in men, male prisoners used to receive Depo-Provera shots in order to suppress their sexual drive and help make them more docile.

Use of Depo-Provera has also been shown to cause a decrease in bone mass. This is most noticeable during the first year of use and is of particular concern for teens. The long term effects of this is unknown and may put users at an increased risk of osteoporosis.

Complications

Although they are rare, there are some serious health complications that can occur with the use of Depo-Provera. Users may have a slightly increased risk of breast cancer and cervical cancer, but study results have been conflicting. Other possible complications include jaundice, blood clots, severe allergic reaction and infertility.

Effectiveness

Depo-Provera is one of the most effective forms of hormonal birth control. On average, the failure rate is only 0.5%. However, the progestin contained within Depo-Provera has been shown to cause fetal defects. Additionally, women who become pregnant while taking Depo-Provera have higher neonatal and infant mortality rates.

Women who are hoping to become pregnant within the next year should not begin taking Depo-Provera. It can take as much as a year before your menstrual system returns to normal after discontinuing the shot.