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What Is the DepoProvera shot?
The DepoProvera shot is an injection given to a patient every 3 months to help prevent pregnancy and/or regulate periods. The shot contains a long acting form of the hormone progestin.
How does the DepoProvera shot work?
The hormone progestin in the birth control shot works by preventing ovulation (the release of an egg during the monthly cycle). Preventing ovulation prevents pregnancy since there is no egg to be fertilized.
The progestin also thickens the mucus around the cervix. This makes it hard for sperm to enter the uterus and reach any eggs that may have been released. The progestin also thins the lining of the uterus so that an egg will have a hard time attaching to the wall of the uterus.
How well does the DepoProvera shot work to prevent pregnancy?
The DepoProvera shot is an effective and reversible birth control method. Over the course of a year, about 6 out of 100 couples who use the DepoProvera shot will have an unintended pregnancy. The chance of getting pregnant increases if the patient returns late (longer than 3 months) to get the next injection. Back-up contraception is needed for 7 days if the DepoProvera shot is started more than 7 days from the last menstrual period.
Who is good candidate for the DepoProvera shot?
Patients who desire a highly effect reversible contraceptive that does not require daily use.
Patients who cannot use estrogen-containing contraceptives.
Patients who desire to eliminate regular menses.
Patients with endometriosis (DepoProvera can reduce pelvic pain related to endometriosis).
Patients with physical or intellectual difficulties that make use of other contraceptives difficult or who desire improved menstrual hygiene.
Who should not use the DepoProvera shot?
Patients with known breast cancer.
Patients who are pregnant or wish to become pregnant within the next year.
Patients with underlying medical problems such as: liver disease, complicated diabetes, hypertension, heart disease, unexplained vaginal bleeding and those on long term steroid therapy.
Does the DepoProvera shot help prevent STIs?
No. The DepoProvera shot does not protect against STIs. Couples having sex must always use condoms along with the shot to protect against STDs.
Are there side effects of the DepoProvera shot?
Many patients who use the DepoProvera shot will have a change in their periods such as irregular periods or no menstrual periods.
Some patients may experience weight gain, especially patients with weight gain in the last 6 months.
Some patients will experience headaches, but a history of headaches is not a contraindication to DepoProvera use.
Progestin hormones can cause or worsen depression symptoms, but a history of depression is not a contraindication to DepoProvera use.
The U.S. Food and Drug Administration (FDA) has issued a safety warning about the use of the DepoProvera shot. Studies show the use of this shot can result in a temporary and reversible loss of bone density in patients. Although bone density may recover when a patient is no longer getting the shot, the loss of bone density seems to be worse when the shot is used for longer periods of time.
Patient who are considering the shot should talk to their doctors about it and make sure that they get enough calcium, vitamin D and exercise each day to promote optimal bone health. Those who smoke should be sure to let their doctors know because smoking may be connected to this bone density loss.
When should I contact my CPCMG Healthcare Team?
If you use the DepoProvera shot, call your doctor if you:
might be pregnant
have a change in the smell or color of your vaginal discharge
have unexplained fever or chills
have belly or pelvic pain
have pain during sex
have heavy or long-lasting vaginal bleeding
have yellowing of the skin or eyes
have severe headaches
feel depressed
have signs of a blood clot, such as lower leg pain, chest pain, trouble breathing, weakness, tingling, trouble speaking, or vision problems
Resources:
UpToDate
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