What is Depo-Provera?
Depo-Provera is a hormone (progestin) given by injection (a needle) every 12 weeks (3 months) to prevent pregnancy.

How does it work?
The hormone stops the ovary from releasing an egg each month. It also makes the mucus in your cervix thicker. This stops the sperm from reaching an egg. These injections, if given every 12 weeks, are 99.7% effective in preventing pregnancy.

Who may want to use Depo-Provera?
Women may want to use this form of birth control if they:

• Can't take the pill because of side effects
• Forget to take the birth control pill
• Are 35 and over and smoke
• Want a birth control method that is private and effective

Who should not use Depo-Provera?

Women should not use Depo-Provera if they:

• May be pregnant now
• May want to get pregnant within 1-2 years
• Have a family history of breast cancer, stroke, blood clots, liver disease or depression
• Will not be able to return for their injection every 12 weeks
• Have any of the following medical problems: abnormal vaginal bleeding, breast cancer or other breast problems, liver problems.

How do I start Depo-Provera?
A physician must prescribe this medication and there will be a cost associated with the prescription. Your health care provider will ask you about your health history and do a breast and Pap exam if it has not been done in the past year. You will be given information and have the opportunity to ask questions before deciding to have the injections. Because this medication stays in your body for many months, you must understand all the information before starting the injection.

If you decide to have the injection, the first needle can be given:

• Day 1-5 of a normal period
• Within the first five days after an abortion or miscarriage
• Six weeks after having a baby

Are there any side effects?
Most women (9 out of 10) have a change in their menstrual bleeding patterns. During the first six months, some women spot on and off, some bleed more frequently, and some don't bleed at all. Usually the amount of bleeding decreases with time but you may not know when to expect bleeding. After 12 months, over 50% of women have no periods and this is normal.

It may take up to two years after the last injection to become pregnant. Most women can get pregnant much sooner (nine months).

A pattern of gaining or losing weight may continue as long as you have your injections. About 38-46% of women gain 1-3 kg (2-7 pounds) in the first year and about 24-40% of women lose weight.

Some women may have other side effects such as depression, headaches, breast tenderness, bloating, less interest in sex, nausea, and acne. Side effects may continue for 6-8 months after the last injection. This does not mean you are protected from pregnancy.

What are the risks for some women?
Women with diabetes, breast cancer or problems with blood cholesterol need to be assessed and followed more closely. Some women with these concerns may not be able to use Depo-Provera. Young teen women who are still growing may have some effect on their bone growth. This may cause osteoporosis later life. There are other factors associated with osteoporosis including diet, exercise, and family history and this is being studied further.

If you have an increase in thirst or increased frequency in urination (peeing), or if you are feeling depressed, report that to the doctor at your next visit.

What is important to remember about Depo-Provera?
You need to get the injection every 12 weeks. If you go longer than 13 weeks you can get pregnant.

Serious side effects are rare but if any of the following happen, see a doctor right away:

• There is an increased risk of blood clots. Symptoms of a clot include repeated very painful headaches, vomiting, dizziness, fainting, visual disturbances, changes in speech, weakness and numbness, sharp chest pain, coughing blood, sudden shortness of breath, severe pain and tenderness in the abdomen and changes in vision.
• Heavy bleeding for twice as long or twice as much as normal should be seen right away.
• On rare occasions, people may have an allergic reaction including hives, itchiness, and/or difficulty breathing. This generally occurs within 15 minutes and you need to get help right away.

Depo-Provera does not protect you or your partner from sexually transmitted infections including HIV/AIDS or hepatitis B. Use a condom every time you have sexual intercourse.

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