Depo-Provera
Depo-Provera is an injection of medroxyprogesterone acetate. It is a progesterone-only form of birth control. It is 99.7 % effective at preventing pregnancy when used consistently every 12 weeks.
A healthcare professional (a nurse, physician, or pharmacist) must give it to you as an injection in the buttocks or in the upper arm.
FAQs
How does it work?
The hormone enters the bloodstream and suppresses ovulation, so that no egg is released from the ovaries. It thickens the cervical mucus making it harder for sperm to travel into the uterus, and thins the lining of the uterus so that it is not suitable for implantation.
How do I start using it?
You should start the depo-provera when on your period, or just after an abortion. You get a prescription from a physician, fill it at the pharmacy, and come to the clinic for injection. At that time, you will be told when you need to come back for the next injection, in 12 weeks time.
When does it start working?
If you start on the last day of your period, or on the day after an abortion, it will start working right away. If you are absolutely positive you have not had sex since your period, it can be given between your periods, but do not rely on it for 7 days. Use condoms or refrain from sex.
Can I miss my period when on it?
Yes, you can. After a year (4 injections) 50% of individuals on Depo have no bleeding. Many people like this aspect of the medication.
Is it safer than the pill, ring or patch?
Yes, for patients who cannot take estrogen, this is a good alternative. There are fewer health risks than there are with the combined oral contraceptive, the ring or the patch.
What if I forget the next injection?
You could become pregnant. Please use back-up contraception (eg. condoms) in the meantime. If you have had unprotected intercourse, we would recommend using the morning-after pill or having an emergency IUD inserted.
What are danger signs that something is wrong?
If you use Depo-Provera for over 2 years, some studies have shown a reduction in bone density measurements. This is reversible, as it is with breastfeeding. However if you are at increased risk for osteoporosis (e.g. are on steroids, have an eating disorder, are an athlete with no menses), you may have increased risk for a fracture when on depo-provera. You should take adequate daily calcium, continue or increase your weight bearing exercises, and stop smoking.
Other Considerations
Many individuals really like the injection for the following reasons
You don’t have to remember a pill each day
Many people stop having a period
It usually reduces cramping during a period
It is private, no one can find a pill packet, or evidence
It is not affected by other medication you may be on
It can be used if you are over 35 and smoke
It is 97 - 99.7 % effective (depends on your perfect use)
It allows for more spontaneous sex as you are protected
Successfully switching from another method
If you are currently using the birth control pill, you can start the injection any time, or at the end of the 21 active-pill days.
If you are using the Ring or the Patch, have the injection on the last day of use, before the period starts.
The first dose may lead to irregular bleeding. Most people are happier by the 2nd or 3rd dose.
Some individuals should not use the injection
People who want to get pregnant soon. It can take an average of 9 months to start ovulating again.
People who are on steroids, who have an eating disorder, or athletes with very low body weight. You may be at increased risk of osteoporosis.
People who have undiagnosed vaginal bleeding
People with breast cancer
People who have serious liver problems
People who have multiple risk factors for heart disease or stroke
People who are breastfeeding (first 6 weeks only)
There are some health benefits to having the injection
It can reduce endometriosis symptoms
It is believed to reduce endometrial cancer
It is reversible: once you stop, you can get pregnant
It will help you avoid pregnancy until you are ready
Some people don’t like the depo-provera injection for the following reasons
It is likely to cause spotting or irregular bleeding, especially for the first 1 - 2 doses. It usually resolves with time.
It may cause hormonal side effects like acne, bloating, nausea or mood changes, including low sex drive
Some people have associated weight gain
You have to see a health professional for the injection
It doesn’t protect against STIs