Depo-Provera what is Depo-Provera? Depo-Provera is an IM intramuscular injection , which means that it is injected into a muscle. It is available in both brand-name and generic form.
Depo-Provera is also available at a lower dose under the name Depo-SubQ Provera , but there is no generic available in that dose. This version is a subcutaneous injection, which means that it is injected just under the skin. The Depo shot begins working immediately with no need for backup birth control if you get it within seven days of the first day of your menstrual period. How does Depo Provera work? How well does it work? Side effects During a normal menstrual cycle, your hormones cause the lining of your uterus to thicken in preparation for a pregnancy.
Other effects A small amount of weight gain sometimes occurs, although many women have no change and some lose weight. Some women may be troubled by headaches, abdominal discomfort and mood changes.
Some women have a reduced interest in sex, particularly women who are prone to depression. A small minority of women experience other side effects, which may be a nuisance but are unlikely to be serious. These include allergic reactions, fluid retention and breast soreness. Advantages Depo Provera is highly effective with a very low failure rate. For many women the loss of periods is an advantage with relief of symptoms such as premenstrual tension and period pain.
Depo Provera is also likely to cause some reduction in risk of ovarian cancer, endometrial uterine cancer, endometriosis and possibly pelvic infection. An injection is given every 12 weeks and no other effort or remembering is required. Learn ways to manage the birth control shot side effect of irregular bleeding and when you should see a doctor. Both the birth control pill and the birth control shot, Depo-Provera, contain hormones.
Learn more and decide if one is right for you. A hormonal intrauterine device IUD is the most effective form of birth control. Once inserted, a hormonal IUD is When it comes to emergency contraception, there can be a lot of confusion.
Natural Cycles and other fertility awareness apps can be an effective way to prevent pregnancy. Our review explains what you need to know. There are alternatives. Thinking about using the birth control ring? Annovera is one of your options — here's how to decide whether it's right for you. You may have noticed both weight loss and gain listed as a side effect of some birth control. But is there a type for loss or maintaining your weight?
However, Depo-Provera CI has not been causally associated with the induction of thrombotic or thromboembolic disorders. Any patient who develops thrombosis while undergoing therapy with Depo-Provera CI should discontinue treatment unless she has no other acceptable options for birth control.
Do not re-administer Depo-Provera CI pending examination if there is a sudden partial or complete loss of vision or if there is a sudden onset of proptosis, diplopia, or migraine. Do not re-administer if examination reveals papilledema or retinal vascular lesions.
Women who have or have had a history of breast cancer should not use hormonal contraceptives, including Depo-Provera CI, because breast cancer may be hormonally sensitive [see Contraindications 4 ]. Women with a strong family history of breast cancer should be monitored with particular care. The results of five large case-control studies assessing the association between depo-medroxyprogesterone acetate DMPA use and the risk of breast cancer are summarized in Figure 1.
Three of the studies suggest a slightly increased risk of breast cancer in the overall population of users; these increased risks were statistically significant in one study. One recent US study 1 evaluated the recency and duration of use and found a statistically significantly increased risk of breast cancer in recent users defined as last use within the past five years who used DMPA for 12 months or longer; this is consistent with results of a previous study 2.
Based on the published SEER incidence rate age-adjusted to the US Standard Population of breast cancer for US women, all races, age 20 to 49 years, a doubling of risk would increase the incidence of breast cancer in women who use Depo-Provera CI from about 72 to about cases per , women.
A statistically nonsignificant increase in RR estimates of invasive squamous-cell cervical cancer has been associated with the use of Depo-Provera CI in women who were first exposed before the age of 35 years RR 1. The overall, nonsignificant relative rate of invasive squamous-cell cervical cancer in women who ever used Depo-Provera CI was estimated to be 1.
No trends in risk with duration of use or times since initial or most recent exposure were observed. Long-term case-controlled surveillance of users of Depo-Provera CI found no overall increased risk of ovarian or liver cancer.
Be alert to the possibility of an ectopic pregnancy among women using Depo-Provera CI who become pregnant or complain of severe abdominal pain. Anaphylaxis and anaphylactoid reaction have been reported with the use of Depo-Provera CI.
Institute emergency medical treatment if an anaphylactic reaction occurs. Persistent injection site reactions may occur after administration of Depo-Provera CI due to inadvertent subcutaneous administration or release of the drug into the subcutaneous space while removing the needle [see Dosage and Administration 2. Discontinue Depo-Provera CI use if jaundice or acute or chronic disturbances of liver function develop. Do not resume use until markers of liver function return to normal and Depo-Provera CI causation has been excluded.
There have been a few reported cases of convulsions in patients who were treated with Depo-Provera CI. Association with drug use or pre-existing conditions is not clear. Monitor patients who have a history of depression and do not re-administer Depo-Provera CI if depression recurs. Most women using Depo-Provera CI experience disruption of menstrual bleeding patterns. Altered menstrual bleeding patterns include amenorrhea, irregular or unpredictable bleeding or spotting, prolonged spotting or bleeding, and heavy bleeding.
Rule out the possibility of organic pathology if abnormal bleeding persists or is severe, and institute appropriate treatment.
As women continue using Depo-Provera CI, fewer experience irregular bleeding and more experience amenorrhea. Women tend to gain weight while on therapy with Depo-Provera CI. From an initial average body weight of lb, women who completed 1 year of therapy with Depo-Provera CI gained an average of 5. Women who completed 2 years of therapy gained an average of 8.
Women who completed 4 years gained an average of Women who completed 6 years gained an average of Two percent of women withdrew from a large-scale clinical trial because of excessive weight gain. A decrease in glucose tolerance has been observed in some patients on Depo-Provera CI treatment. Monitor diabetic patients carefully while receiving Depo-Provera CI. Detectable amounts of drug have been identified in the milk of mothers receiving Depo-Provera CI.
In nursing mothers treated with Depo-Provera CI, milk composition, quality, and amount are not adversely affected. Neonates and infants exposed to medroxyprogesterone from breast milk have been studied for developmental and behavioral effects through puberty.
No adverse effects have been noted. Because progestational drugs including Depo-Provera CI may cause some degree of fluid retention, monitor patients with conditions that might be influenced by this condition, such as epilepsy, migraine, asthma, and cardiac or renal dysfunction.
Return to ovulation and fertility is likely to be delayed after stopping Depo-Provera CI. Of the women who discontinued the study to become pregnant, became pregnant. The median time to conception for those who do conceive is 10 months following the last injection with a range of 4 to 31 months, and is unrelated to the duration of use. Although Depo-Provera CI should not be used during pregnancy, there appears to be little or no increased risk of birth defects in women who have inadvertently been exposed to medroxyprogesterone acetate injections in early pregnancy.
Neonates exposed to medroxyprogesterone acetate in-utero and followed to adolescence showed no evidence of any adverse effects on their health including their physical, intellectual, sexual or social development. A woman who is taking hormonal contraceptive should have a yearly visit with her healthcare provider for a blood pressure check and for other indicated healthcare.
The use of Depo-Provera CI may change the results of some laboratory tests, such as coagulation factors, lipids, glucose tolerance, and binding proteins. The following important adverse reactions observed with the use of Depo-Provera CI are discussed in greater detail in the Warnings and Precautions section 5 :.
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical studies of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.
In the two clinical trials with Depo-Provera CI, over 3, women, who were treated for up to 7 years, reported the following adverse reactions, which may or may not be related to the use of Depo-Provera CI.
The patients received mg Depo-Provera CI every 3-months 90 days. The median study duration was 13 months with a range of 1—84 months. The following adverse reactions have been identified during post approval use of Depo-Provera CI.
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