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Depo-Provera (contraceptive injection)By Mayo Clinic staff
Original Article: http://www.mayoclinic.com/health/depo-provera/MY00995
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Depo-Provera is a well-known brand name for medroxyprogesterone acetate, a contraceptive injection for women that contains the hormone progestin. Depo-Provera is given as an injection once every three months. Depo-Provera typically suppresses ovulation, keeping your ovaries from releasing an egg. Depo-Provera also thickens cervical mucus to keep sperm from reaching the egg.
Medroxyprogesterone acetate is also available in a lower dosage. This version is called Depo-subQ Provera 104. While Depo-Provera is injected deep into the muscle, Depo-subQ Provera 104 is injected just beneath the skin. Depo-Provera and Depo-subQ Provera 104 have similar benefits and risks. However, less long-term information is available about the effectiveness of Depo-subQ Provera 104.
To use Depo-Provera or Depo-subQ Provera 104, you'll need a prescription from your doctor or other health care provider.
Why it's done
Depo-Provera is used for contraception. Your health care provider might recommend Depo-Provera if:
- You don't want to take a birth control pill every day
- You want or need to avoid using estrogen
- You're breast-feeding — Depo-Provera doesn't contain estrogen, which can affect milk supply
- You're age 35 or older and smoke
- You have health problems such as anemia, seizures, sickle cell disease, endometriosis or uterine fibroids
Among various benefits, Depo-Provera:
- Doesn't require daily attention
- Eliminates the need to interrupt sex for contraception
- Decreases menstrual cramps and pain
- Decreases the risk of pelvic inflammatory disease and endometrial cancer
Depo-Provera isn't appropriate for everyone, however. Your health care provider may discourage use of Depo-Provera if you have:
- Unexplained vaginal bleeding
- Breast cancer
- Liver disease
- A history of blood-clotting problems
- Sensitivity to any components of Depo-Provera
- Risk factors for osteoporosis
In addition, tell your health care provider if you have diabetes, depression, or a history of heart disease or stroke.
In the first year of typical use, an estimated 3 out of 100 women using Depo-Provera will get pregnant.
After stopping Depo-Provera, it may be 10 months or more before you begin ovulating again. If you want to become pregnant in the next one to two years, Depo-Provera might not be the right birth control method for you.
Depo-Provera doesn't protect against sexually transmitted infections. In fact, some studies suggest that hormonal contraceptives such as Depo-Provera may increase a woman's risk of HIV. It is not clear whether this association is due to the hormone or behavioral issues related to the use of reliable contraception. In light of these findings, the World Health Organization and other medical groups are re-examining the research on hormonal contraception and risk of HIV. If you're concerned about HIV, talk with your health care provider. He or she may suggest using condoms in addition to Depo-Provera.
Side effects of Depo-Provera may include:
- Abdominal pain
- Breast soreness
- Decreased interest in sex
- Irregular periods and breakthrough bleeding
- Loss of bone mineral density that may not be completely reversible
- Weakness and fatigue
- Weight gain
Consult your health care provider as soon as possible if you have:
- Heavy bleeding or concerns about your patterns of bleeding
- Pus, prolonged pain, redness, itching or bleeding at the injection site
- Severe lower abdominal pain
- Serious allergic reaction
- Signs of a blood clot in your leg, such as persistent pain in your calf
- Signs of a blood clot in your lung, such as coughing blood, sharp chest pain or sudden shortness of breath
- Signs of a stroke, such as a sudden severe headache, problems with vision or speech, or numbness in an arm or a leg
- Signs of a blood clot in your eye, such as sudden partial or complete blindness
- Other eye problems, such as double vision
- Signs of jaundice, such as yellowing of the skin or whites of the eyes
- Sudden onset of severe headaches
Many experts believe progestin-only contraceptive methods, such as Depo-Provera, carry significantly lower risks of these types of complications than do contraceptive methods that contain both estrogen and progestin.
How you prepare
You'll need to request a prescription for Depo-Provera from your health care provider. He or she will review your medical history and check your blood pressure. Talk to your health care provider about any medications you're taking, including nonprescription and herbal products. If you're interested in giving yourself Depo-Provera injections at home, ask your health care provider if that's an option.
What you can expect
To use Depo-Provera:
- Consult your health care provider about a starting date. To make sure you're not pregnant when you're injected with Depo-Provera, your health care provider will do your first injection within five days of the start of your period. If you've just given birth and you're not breast-feeding, your first injection will be done within five days of giving birth. If you're breast-feeding, your first injection will be done six weeks after you give birth. You can start Depo-Provera at other times, but you may need to take a pregnancy test first.
- Prepare for your injection. Your health care provider will clean the injection site — either the upper arm or buttocks for Depo-Provera or the abdomen or upper thigh for Depo-subQ Provera 104 — with an alcohol pad. After the injection, don't massage the injection site. Depending on when your start date is, your health care provider may recommend that you use a backup method of birth control for seven days after your first injection. Backup birth control isn't necessary after subsequent injections as long as they're given on schedule.
- Schedule your next injection. Depo-Provera injections must be given every 12 weeks. If you wait longer than 13 weeks between injections, you may need to take a pregnancy test before your next injection to verify that you aren't pregnant.
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