Is Depo-Provera the Right Contraceptive Method for You?

Weight the pros and cons of quarterly contraception

IAN HOOTON/Science Photo Library/Getty Images

What could be easier than Depo Provera, a contraceptive that comes in the form of a shot that you only have to take every three months? The Depo-Provera contraceptive Injection lasts for 13 weeks and is highly effective at preventing pregnancy with a failure rate of less than 1 percent.

There are no daily pills to remember, no IUD strings to check, diaphragms or cervical caps to worry about inserting into the proper position; all you have to do to achieve effective contraception is have the Depo-Provera injection on a regular schedule every 13 weeks.

Does it sound too good to be true... almost like the perfect contraceptive? Are there any risks associated with the use of Depo-Provera? How does Depo-Provera prevent pregnancy? What about possible side effects?

These are all questions you should answer before making a decision about Depo-Provera as well as other contraceptives.

How Depo-Provera Works

The Depo-Provera injection prevents pregnancy by preventing the ovarian egg cells from maturing and releasing from the ovary. If an egg does not mature and release from either ovary, there is no egg to be fertilized by sperm and pregnancy cannot occur. The contraceptive shot also changes the condition of the lining of the uterus so that pregnancy is less likely to occur.

What Are the Benefits of Depo-Provera?

The Depo-Provera contraceptive injection is a long-lasting method of contraception that protects you from pregnancy for three months without the bother of remembering a daily pill.

It is a progestin only form of contraceptive that does not contain the estrogen found in many oral contraceptives. It is safe for nursing mothers when used as directed.

Unlike the IUD, it cannot be expelled by the body, leaving you, sometimes unknowingly, unprotected from pregnancy. The contraceptive protection of the Depo-Provera shot can be stopped at any time by simply not getting the next injection; most women who become pregnant do so within 12 to 18 months after their last injection.

Is privacy about contraception important to you? With the contraceptive injection, there are no pill packs to keep up with; you don't have to worry about checking for IUD strings; you don't have to stop to insert a diaphragm or cervical cap before sexual intercourse; and unlike contraceptive implants, it cannot be seen or felt--all reasons that make Depo-Provera probably the most private form of contraceptive available.

What Are the Risks of Depo-Provera?

The first year of Depo-Provera use is likely to cause some changes to your menstrual cycle including irregular or spotting bleeding, an increase or decrease in the amount of menstrual bleeding, or a complete absence of menstruation.

Any continuous or excessive bleeding should be reported to your physician. Other risks associated with the Depo-Provera contraceptive injection include an increased risk of bone loss. Women who are under 35 and whose first exposure to Depo-Provera was within the last four years may have a slightly increased risk of breast cancer, similar to the risk seen with oral contraceptives.

What are the side effects of Depo-Provera?

The most common side effects of Depo-Provera include:

  • Irregular menstruation
  • Absence of menstruation (amennorhea)
  • Weight gain
  • Headaches
  • Anxiety
  • Stomach pain or cramps
  • Dizziness
  • Weakness or fatigue
  • Loss of libido

According to one gynecologist, the most common side effect he sees in his practice is bloating, followed by irregular or spotting periods. About half of his patients find the side effects unacceptable and do not continue with Depo-Provera following the first injection; however the other half often continue Depo-Provera over six, nine, 12 months and longer.

When side effects such as bloating and irregular menstruation occur, he sometimes prescribes either one month of oral contraceptives or a hormone frequently used for menopausal HRT which usually is effective at relieving the side effects.

He said that women who continue the Depo-Provera injections for two or three series (six or nine months) tend to stop having side effects.

Who Shouldn't Use Depo-Provera?

Women who think they could be pregnant should not have the Depo-Provera injection until pregnancy is completely ruled out. If you have had breast cancer, you should not use Depo-Provera, as well as women who have had a stroke, blood clots (phlebitis) in the legs, or women who have liver problems or disease. If you are experiencing abnormal bleeding and the cause has not been determined, you should not use Depo-Provera.

You should have a pelvic exam before your physician prescribes Depo-Provera. If you have any of the following conditions, it's important that your physician is aware of these health issues before you receive the Depo-Provera contraceptive injection:

Of course, it's always important to inform your physician of any over-the-counter, prescription, or herbal medications that you are taking.

When Is the Right Time for Depo-Provera?

Now that you have the facts, if Depo-Provera sounds like something you would like to try, your first step is to make sure you have the injection at the proper time in your menstrual cycle. The first injection of Depo-Provera must be given only during the first 5 days of normal menstruation.

Women who want to use Depo-Provera following a pregnancy must have the shot within five days of birth if not breastfeeding, or six weeks after childbirth if they are breastfeeding. Each subsequent injection of Depo-Provera must be taken at regular 13-week intervals to effectively prevent pregnancy from occurring. Ask your physician for your return appointment when you receive your first injection of Depo-Provera.

Contraceptives and STDs

Remember, the Depo-Provera contraceptive injection does not protect against sexually transmitted diseases (STDs); it only prevents pregnancy when used as intended on a regular schedule.

Unless you are in a long-term monogamous relationship, you should always use a condom in addition to all other methods of contraception to help prevent STDs such as chlamydiagenital herpesgonorrhea or HIV/AIDS.

Always contact your healthcare provider when you have questions or experience side effects while using contraceptives as well as when you are concerned about STDs or other health issues.

Continue Reading