Depo Provera is a long-acting form of contraceptive. It is a synthetic form of progesterone (one of the female hormones involved in pregnancy and the menstrual cycle) that is administered by giving an intramuscular injection. This will usually be into the buttock, as the gluteus maximus is the largest area of muscle in the body, but you may also be given the option of having it in either the arm or the leg. Generally, each injection will be effective for a period of twelve weeks, at which point the next dose is required. If you are getting the Depo shot for the first time, it is usually recommended that you have it during your period (which ensures that you are not pregnant), and that you use an additional form of contraception, such as condoms, for the first seven days, to allow the drug time to take effect.
How does Depo Provera work?
Like the majority of hormonal contraceptives, Depo Provera changes the levels of hormones that are naturally found in the body. As this is a progesterone-based contraceptive, it works by mimicking the hormone levels that occur during pregnancy. An increased amount of progesterone is present during pregnancy, and will act to prevent the breakdown of the uterus lining and to prevent ovulation, so no more eggs are released from the ovaries. Depo Provera also prevents ovulation because it raises your level of progesterone.
This long-acting contraceptive is one of the most effective ways to prevent pregnancy, as long as the repeat injections are carried out on time. There is no need to remember to take tablets at the same time every day, and all you need to do is book an appointment with your practice nurse every twelve weeks.
What are the side effects of Depo Provera?
The most obvious effect of Depo Provera, and indeed its purpose, is to prevent pregnancy, which it does very effectively. However, as with any drug, there are a number of potential side effects which you may experience, so you should be aware of these before you make your choice about which type of contraceptive would be most suitable for you.
- The use of Depo Provera can change the monthly cycle and alter menstrual bleeding. This is something that many women actually consider to be an advantage, and is the reason they choose the Depo jab in the first place. After a year of using this form of contraception, 55 percent of women no longer experience a monthly cycle (this is known medically as amenorrhoea), and this increases to 68 percent after two years. However, it is also possible that irregular bleeding can occur for the first few months of use, and a small proportion of women experience heavier bleeding after using Depo Provera.
- Depo Provera is a long-acting contraceptive. Although it is necessary to have the injections every twelve weeks to ensure that it will remain effective, it can take several months for fertility to return to normal after stopping usage of the drug. On average, it will take around nine months for fertility to return to its normal level, and in some cases as long as eighteen months. Therefore, if you are considering a pregnancy in the near future, Depo Provera is probably not the ideal contraceptive for you.
- Depo Provera does not provide protection against sexually transmitted diseases, which is something you should take into consideration. However, neither do any other forms of hormonal contraceptive.
- It is thought that the use of Depo Provera can lead to the weakening of the bones, and for this reason it has a “black box warning” on the packaging. However, the evidence from different studies is conflicting, so the FDA (United States Food and Drug Administration) and the WHO (World Health Organisation) have both stated that the use of Depo Provera should not be restricted for this reason. Many doctors, however, are still reluctant to prescribe Depo shots for longer than two years, despite no definitive evidence of its effects on bone loss and the risk of osteoporosis.
Other effects that may result from the use of Depo Provera include abdominal pain, changes in weight, headaches and fatigue. However, many side effects are extremely rare, with menstrual changes being the only one that is seen on a regular basis.
Is Depo Provera suitable for me?
The majority of women are able to use Depo Provera without experiencing any significant side effects, beyond changes to the menstrual cycle. However, there are some groups of women who may not be able to use this form of contraception. If you have liver disease, breast cancer or are prone to blood clots, then hormonal contraceptives, including the Depo shot, would be inadvisable. If you have had unexplained vaginal bleeding, then it may not be the most suitable contraceptive for you, due to the changes in periods that frequently occur with use of the drug.
Is there anything else I should know?
Depo Provera is a popular choice for long term contraception among many women because it is easy and convenient to use. If used for a considerable period of time, then it may lead to the loss of bone density, increasing the risk of osteoporosis. For this reason, it is advised that women using Depo Provera have enough calcium and vitamin D in the diet. You may want to discuss the possibility of taking supplements with your doctor if this is a concern.