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It's a shot of synthetic progesterone that you get every three months to prevent pregnancy. If you're religious about having your shots on time, it's more than 99 percent effective. Progesterone (which is also used in many birth control pills) prevents you from ovulating; thins the lining of your uterus, making it hard for an egg to lodge there if one does slip through; and thickens the mucus around your cervix, which can keep sperm from entering. Depo-Provera won't protect you from sexually transmitted diseases.

First you'll need a physical to insure you don't have any conditions that would make Depo-Provera a bad choice for you. Your gynecologist or a health-care worker at a women's clinic will give you the injection in your buttock or upper arm. She or he will usually recommend that you get the first one just after your period, so you can be absolutely sure you're not pregnant. You may want to use a backup method like condoms for a week after your first shot. Subsequent shots will be effective in 24 hours, as long as you're getting them regularly. Each one costs between $30 and $75, depending on where you have it done.

In November 2004, the US Food and Drug Administration announced that a new "black box" warning would be added to Depo-Provera advising that the contraceptive may cause a loss in bone density. A black box warning is designed to alert prescribing doctors to serious side effects or health risks associated with a product. The FDA warns that the longer you use Depo-Provera, the more likely you are to lose bone density. The organization says not to use Depo-Provera over a long period (more than two years) unless you have no other satisfactory alternative.

Depo-Provera may also cause irregular periods or spotting for the first three to six months, but many women eventually stop menstruating altogether while they're on Depo-Provera. This means you're less likely to become anemic, since you won't be losing all that iron in your menstrual blood. It also significantly reduces the risk that you'll develop endometriosis, acute pelvic inflammatory disease, or cancer of the uterus (endometrial cancer). On the other hand, you might also notice less pleasant side effects, such as weight gain, headaches, nausea, dizziness, acne, breast tenderness, decreased sex drive, nervousness, insomnia, or moodiness. Call your doctor if you develop a skin rash or itching, or if you have trouble breathing after a shot; you may be allergic to this form of progesterone.

A study by National Institutes of Health researchers released in 2004 suggests that using Depo Provera could make women more susceptible to sexually transmitted diseases. Women in the study were three times as likely to develop chlamydia or gonorrhea as women who were not using a hormonal contraceptive. While researchers don't fully understand the link between the contraceptive and the increase in STDs, they caution that women on Depo Provera who are in non-monogamous relationships should use condoms regularly to protect themselves from infection.

Depo-Provera has no permanent effect on your fertility, but it may take you up to a year after the injections stop to begin ovulating again. Your menstrual periods may return to normal in six months to a year, but that's not an indication of your fertility.

Because your fertility may take a long time to come back after you stop getting the shots, don't start Depo-Provera if you think you might want to get pregnant in the next 18 months. This method also isn't a good choice if you have a history of unexplained vaginal bleeding, major depression, diabetes, breast cancer, or any liver disease (including hepatitis and abnormal results on liver-function tests). The American Heart Association advises women with cardiovascular risk factors to review their situation carefully with their doctor before deciding whether to take Depo-Provera. A small English study found that Depo-Provera interfered with arteries' ability to expand and contract, increasing the risk of heart disease in susceptible individuals. You can use Depo-Provera while breastfeeding, but only after your child is older than six weeks.

References

First published July 15, 1999
Last updated February 14, 2008
Copyright © 1999 Consumer Health Interactive

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