DEPO PROVERA - a patient's guide
Editorial Team

Overview

Depo Provera in an injection for contraception.

The injection is effective for three months.

It is nearly 100 percent effective.

It is useful for women who often forget to take their contraceptive pill.

Depo Provera may stop periods or cause heavy periods in some cases.

It does not contain oestrogen.

Fertility can take about six months to return after the last injection.

What is it?

Depo Provera is an injection for contraception.

Also known as DMPA, Depo Provera contains depot medroxyprogesterone acetate.

Depo Provera contains a man-made form of the female hormone progesterone. It is a progesterone-only contraceptive, in contrast to the combined oral contraceptive pill which also contains the female hormone oestrogen.

It is normally given as an injection of a 150mg dose into the thigh or buttocks every three months, and is available in most countries around the world.

Depo Provera works by stopping ovulation, thus preventing pregnancy. Many women will not menstruate or have light periods while on the contraceptive.

The injection is nearly 100 percent effective at preventing pregnancy - more effective than "the Pill".

Advantages

Depo Provera is nearly 100 percent effective

It does not rely on someone remembering to take it

It is convenient and does not interfere with intercourse

It can be reversed, after a time delay

There are often lighter, and less painful menstrual periods

Reduced feelings of pre-menstrual tension

Reduced incidence of pelvic inflammatory disease

Less risk of fallopian tube pregnancy

A possible reduction in the rate of endometriosis

Reduced risk of endometrial cancer

Lactation is not stopped from the use of Depo Provera

No side effects from oestrogen

Antibiotics do not affect it

No one else needs to find out you are taking a contraceptive

Disadvantages

The injection cannot be immediately reversed once it has been given

Disturbed menstrual cycle, with wide variation in periods. There may be no periods in some women, or frequent, or heavy periods in others

Possible loss of bone in some women who have not had a period for some time

Delay in the return to fertility. It may about six months after an injection for fertility to return, and up to two years in some cases

Weight gain. Some women gain up to 2kg in the first year on the injection

Possible adverse affects on the foetus if pregnancy occurs

An increase in acne, but this is uncommon

A possible recurrence of bed wetting in women who wet the bed as adolescents

The chance of an allergic reaction to the injection

Some women complain of depression, a reduced sex drive, vaginal dryness, breast tenderness, cramps and headaches while on the injection.

Depo Provera does not provide a steady dose of hormone to prevent contraception. The levels are high straight after the injection and then the hormone levels decline.

The injection can cause heavy and prolonged bleeding if it is given earlier than six weeks after child birth.

Drugs such as Rifampicin and anticonvulsant medicines may reduce the effectiveness of Depo Provera, particularly towards the end of the injection cycle. It is recommended injections be given every 10 weeks, instead of every 12 weeks in these cases.

There is no strong link with breast cancer for Depo Provera, however, in one study some Beagle bitches who were given huge doses of the drug did develop breast cancer. These results are not believed to be relevant for human beings.

When should the injection be given?

For women menstruating and not on the pill, the first injection is recommended before day 5 of the menstrual cycle - no longer than five days after the start of your period.

Depo Provera begins to work immediately, however, extra precautions such as condoms are sometimes recommended for seven days following the first injection.

Women taking the Pill can have the injection at any time.

New mothers are advised to wait for six weeks after birth before having an injection.

Women who have had a pregnancy termination or miscarriage should have the injection within 7 days of the event, and no other precautions are necessary.

Depo Provera is not recommended for women over the age of 45, or who have a history of breast cancer.

Who are the best candidates for Depo Provera?

Depo Provera is useful in women who cannot tolerate preparations which contain oestrogen such as the oral contraceptive pill.

Forgetful pill takers.

It can be used as an alternative to an IUD where there is a concern about pelvic inflammatory disease.

Getting help

Your doctor, or Family Planning Clinic will be able to help.