THE SHOT

Depo-Provera is worth considering if you want long term contraception without following a daily routine. Since protection is maintained from a shot every 3 months, it allows for sexual spontaneity. It may also be a good choice for you if you cannot remember take a pill everyday or if you cannot use birth control containing estrogen (i.e. you are over 35 and a smoker or have a history of blood clots. ) It is also a good choice if you do NOT plan to become pregnant in the near future and want a reliable form of birth control other than the pill. The shot does not protect from sexually transmitted diseases particularly HIV. If this is a concern you should use a condom as well.

Most women of any age needing birth control can use Depo-Provera. A woman should not use the shot if she has history of:

• active liver disease
• current or past history of breast cancer
• unexplained vaginal bleeding

* The final decision is between you and your doctor.

irregular bleeding

• Almost all women who use Depo-Provera will experience changes in their period, including irregular or unpredictable bleeding or spotting, and occasionally heavy or continuous bleeding. This tends to subside the longer you use this method. After a year of use, one-half of women will stop having a period altogether. This is an expected side effect from the shot and is NOT a medical problem. The constant release of hormone in your body from the injection prevents the lining of the uterus from building up; therefore, there is nothing to bleed off each month. If the irregular bleeding is interfering with your lifestyle, talk to your health care provider. This condition can be treated by either taking a short course of estrogen (i.e. taking the birth control pill) or medications such as Motrin or Advil to regulate your cycle for a few months until the irregular bleeding resolves.
• weight gainDepo-Provera has been shown to be associated with weight gain. As much as 3 to 5 lbs. in the first year of use. This is most likely due to increased appetite from the progestin. If you watch what you eat and exercise regularly you can offset this weight gain.

delay in the return of your period

• Although the shot does NOT cause infertility, it may take 12 to18 months from your last injection for your normal menstrual function to return (the average is 10 months). Thus, if you are considering pregnancy in the near future you may want to consider an alternative method of birth control.

no immediate discontinuation

• Unlike, the pill or mini pill, the hormone given as an injection can take several months to clear from your body. Thus, you may be “stuck” with some of the other side effects such as irregular bleeding, weight gain, etc. for several months.

reversible loss of bone mass

• Women who use Depo-Provera for a long period of time may have lower density than non-users. This will reverse after stopping the Depo-Provera and has not been shown to cause osteoporosis or associated fractures. Women over 40 who continue this method for greater than 2 years would benefit from having their bone density checked.

mood changes

• Some women experience mood changes on the shot-depression, irritability, and change in sex drive. These are infrequent side effects

• easy to use–all you have to remember is to go to your health care provider for a shot 4 times a year
• extremely reliable-this form of birth control has one of the lowest failure rates
• confidential–no one other than your health care provider needs to know you are using it
• decreases menstrual cramps and blood loss–after 1 year of use 50% of women will no longer get their period
• reversible–although expect a delay in the return of your period of 10 months on average

We will only give you the Depo-Provera within 5 days of the start of your menstrual period. This ensures that you are NOT pregnant when you receive the shot and it will be effective immediately. Before you get each shot, we will check that you have a negative urine pregnancy test.

Another time to start this method is after the end of a pregnancy; either at the time of termination of pregnancy or within 5 days postpartum if NOT breastfeeding. If you plan to breastfeed, Depo-Provera is a safe method of birth control, but we recommend waiting until 6 weeks postpartum when the milk supply is fully established. If you initiate Depo-Provera after the birth of a child, keep in mind the delay in return of your menstrual cycle. If you are planning to have another baby within the next year or so, you may want to select a different form of birth control.