If you are one of those women who prefer to not have to think about a pill everyday for birth control or the regular use of patches or other types of contraceptives, you may favour a more long term contraceptive, like the birth control shot - depo provera. While extremely effective, depo provera does come with its own pros and cons. Therefore, make sure you are well informed before trying this contraception method.
What is Depo-Provera?
Depo-provera, also known as DMPA, is a hormonal injection of progestrone that is given every 11 to 13 weeks and is a reversible method of birth control. This hormonal dose does not contain any estrogen, thereby making it safe for breastfeeding mothers too. This progestin-injection is similar to the hormone progestrone naturally created in your body to regulate the menstrual cycle.
How Does it Work?
Like other hormonal methods of birth control, the depo provera birth control works in three ways:
- It prevents the ovaries from releasing an egg each month.
- It thickens the mucous of the cervix so that sperm cannot travel easily through the vagina.
- It affects the uterine lining, which is believed to make implantation of a fertilised egg difficult.
One of the more convenient facets of using depo provera as compared to other contraceptives is that you only four injections about every three months to prevent pregnancy for a whole year.
Use of Depo Provera
Your health care provider will be the best judge to know whether you are suited for using this type of birth control. In general, some conditions that may require you to opt for other contraceptive methods are:
- If you have unexplained vaginal bleeding
- Liver diseases
- You are planning pregnancy or you have suspected pregnancy
- Gall bladder disease
- Concerned about weight gain
- History of depression
- Allergic to its use
- History of blood clots
- Cancer of the breast or other organs
- Fear of injections
Long-term use of depo provera is usually not recommended and especially not for young women whose bones are still in the developmental stage, as use of depo provera has been linked to a loss of bone mass.
A typical depo provera schedule consists of one dose four times a year. Your doctor will first make all the necessary physical examinations and then give you the first intramuscular injection during the first seven days of your period. One dose of this contraceptive injection will be enough to prevent pregnancy for approximately 12 weeks.
Many women take their next dose in around 11 weeks to avoid the last moment tension and stay protected. If due to any circumstance you do miss a shot or delay till the 13th week, it is advisable to use secondary birth control methods, like a condom or a diaphragm, until you get your next shot. During this time, it is also important for you to check for pregnancy, as receiving depo provera while pregnant may cause premature birth.
Contraception using depo provera injection has been found to be more effective than any other kinds of birth control. It is 97% to 99.7% effective in preventing birth, though it cannot protect you from STDs, like herpes or gonorrhoea.
The affect of the hormone starts as soon as you take an injection and if you are regular in your menstrual cycle, the chances of getting pregnant are very rare. Some drugs, such as those taken for Cushing’s syndrome, may lessen the effects of this contraceptive. Do tell your doctor about all the medications you are taking and use a secondary contraception if advised.
Depo Provera Side Effects
One of the major side effects of depo provera is the irreversible loss of bone density with prolonged use. This may also lead to the higher risk of osteoporosis in women. Therefore, it is always recommended that you should not use this contraceptive for more than two years. Women are also advised to exercise and take in a lot of calcium while using this method.
Weight gain is another side effect that has been observed in more than 70% of women using depo-provera. The gain may vary from 5 to 10 pounds, making regular exercise all the more important.
Other depo-provera side effects include:
- Irregular, heavy or loss of menstrual cycle. The chances of getting periods reduces the longer you take the injections, though normal cycles should resume within 14 weeks of stopping the birth control.
- Mood changes
- Breast tenderness
- Decreased sex drive
- Hair loss
- Muscle pain
- Heart palpitations
It is rare for someone to be seriously effected by this contraceptive. However, there are some complications associated with its use, including:
- Blood clots
- Severe allergic reaction
- Severe depression
- Heavy or prolonged vaginal bleeding
Additionally, there is conflicting evidence to suggest that use of depo-provera may increase your risk of breast and cervical cancer, although no definite conclusions have yet been drawn.
Some of the health benefits of using this method are:
- Low risk of ovarian or endometrium cancer
- Decreased risk of pelvic inflammatory disease
- Less menstrual cramping
- Fewer periods
- Lower chance of anaemia
Other advantages are:
- Easy to take; does not require daily ingestion or application
- Effective within 24 hours
- Does not interfere with intercourse
- Can be used by breastfeeding mothers
- You can start using it as early as 6 weeks after childbirth
- Has no estrogen
- Effective for 12 weeks
Drawbacks to depo-provera include:
- Loss of bone density
- Increased risk of osteoporosis
- Has to be taken every 3 months
- Delay in the return of fertility after stopping injections
- Weight gain
- Does not protect against sexually transmitted diseases
- Irregular bleeding
After Depo Provera
The effect of using a depo provera injection does not cease immediately after you stop taking the contraceptive. Though you may choose to stop it anytime and you may start ovulating immediately, it usually takes a period of 6 to 10 months to regain complete fertility.
Other birth control side effects typically associated with hormonal contraceptives, like weight gain, breast tenderness, and depression, may become lesser gradually as the body gets clear from the effect of the hormonal injection. If you are considering pregnancy after depo provera, you might have to wait as long as a year for the positive signs.
Once you have stopped the injections, drinking lots of water and juices, eating organic vegetables and fruits, and exercising may help the body regain fertility rapidly. Some women also prefer taking a detoxifying session or going to a sauna to clear the body of the hormone.
Availability and Cost
The depo provera injection can be taken in any fertility clinic or given by a private practitioner. Before the first dose, you will need to be examined thoroughly by your health care provider. The cost of depo provera injection can vary according to where the shot is administered, although family planning clinics usually charge less than private clinics. Some forms of insurance may cover all or part of the cost of the injection.