Contraception
Contraceptive Methods
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Injection (Depo-Provera®)
Depo-Provera® is a hormonal birth control method that contains a progestin. It does not contain estrogen. It is administered by a needle in the muscle of the arm or buttocks every 12-13 weeks. It is 99.7% effective in preventing pregnancy, but causes loss of bone density. Because of this, Depo-Provera® is usually only recommended for people who are unable to take other contraceptive methods. The injection should be used with condoms to prevent sexually transmitted infections (STIs).
How it works
It stops your ovaries from releasing an egg every month (ovulation). It also thins the lining of the uterus.
Benefits
With this method of birth control, you only have to think about it 4 times a year! You do not have to remember to take it every day. It is reversible.
Fifty percent of women will stop having periods all together (amenorrhea) within the first year of starting Depo-Provera®. This is not unhealthy and, for women who have heavy or painful periods, this may be a positive side effect.
Depo-Provera® can be used by breastfeeding mothers. It has no effect on breast milk production. It also decreases the risk of endometrial cancer.
Disadvantages
Depo-Provera® is associated with a decrease in bone mineral density. For this reason, it is recommended when other birth control methods are not a good option.
Depo-Provera® does not protect against sexually transmitted infections (STIs) or HIV. Condoms should still be used to protect against STIs or HIV. Women must return to their health care provider every 12-13 weeks to receive their next injection.
Side-effects
The most common side effects are irregular bleeding and weight gain, although they do not happen to every user. Some hormonal side effects have been reported but only occur in a small number of users.
Irregular bleeding
Irregular bleeding is common in the first few months of use. Some women have no bleeding, some women have spotting, and some women experience heavier bleeding. The bleeding usually decreases with time. By one year, 50% of women will stop having periods altogether.
Weight gain
The average weight gain in the first year of use is approximately 5 pounds. This may be due to increased appetite and an increased food intake.
Decreased bone density
There is a decrease in bone density in women who use the injection, similar to that seen in women who have breastfed for 6 months. Bone density improves when the injections are stopped. This bone density loss is of particular concern for young women in their teens, whose bones are still hardening. The impact of this decrease in bone density is unknown for perimenopausal or postmenopausal women. Women using Depo-Provera® should make sure that they get enough Calcium and Vitamin D, either in their diet or in vitamin supplements, in order to help protect their bones.
Return to fertility
A woman's return to fertility with this method can be longer than with the oral contraceptive pill. It takes an average of 9 months after your last injection to return to your regular menstrual cycle pattern.
How to take it
The first injection should be given during the first 5 days of the menstrual cycle. It becomes fully effective 24 hours after the injection. Your next injection is given within 12-13 weeks of your last injection.
Your health care provider or nurse will administer the injection to you. A prescription is required. The cost is about $40.00 for each injection that lasts about 3 months.
Troubleshooting: What if you are late for your next injection?
It is important to get your next injection within 12 weeks of your last injection. Late for your next appointment? If you wait longer than 14 weeks, a pregnancy test should be done before you receive your next injection. A non-hormonal method of birth control (eg. condoms, diaphragm, cervical cap) should be used until you receive your injection and for two weeks after your injection.
updated: 05/18/06
Last Modified: September 5, 2006
