Depo Provera
What it is . . .
Depo Provera is a progesterone-only injection given every 12 weeks. The injection is intramuscular meaning it is given directly into the muscle of the shoulder or cheek of the bum.
How it works . . .
Depo Provera works by:
1. Stopping ovulation
2. Changing the lining of the uterus to make it harder for a fertilized egg to implant
3. Thickening the cervical mucus making it more difficult for sperm to get into the uterus
Who shouldn't take it . . .
Women who:
1. Are pregnant
2. Want to become pregnant in the near fuuture - fertility may take up to two years to return
3. Have lumps, swelling or tenderness of the breast not known about by the doctor
4. Have unusual or unexplained vaginal bleeding not known about by doctor
5. Liver problems or disease
6. Are taking blood thinners
7. Are allergic to any of the ingredients in Depo Provera
The doctor should be made aware if the woman seeking Depo Provera has a personal or family
history of the following conditions. These women may need more frequent follow-up.
1. Breast cancer, abnormal breast exam or mammogram
2. Diabetes
3. Migraines
4. Heart problems
5. Kidney problems
6. Depression
7. Seizures, convulsions or epilepsy
8. Asthma
9. Stroke or blood clots
10. High blood pressure
11. Scanty or irregular periods
What are the side effects . . .
Women should be made aware that Depo Provera is effective for 3 months and that
side effects may continue after the birth control effect is over.
1. Changes in menstrual periods are almost guaranteed to occur. Changes such as:
-prolonged bleeding
-irregular bleeding
-no bleeding
2. Return to fertility may be delayed. Most women will have to wait at least 6-8 months after the last injection to start ovulating, have regular periods, and be able to become pregnant.
3. Weight gain due to an increase in appetite. If more than 15 pounds over a short period of time, the doctor should be advised.
4. Women with a history of depression may find that Depo will worsen the condition.
Other possible side effects include:
1. Headaches
2. Nausea or vomiting
3. Nervousness
4. Stomach cramps
5. Backache
6. Stomach bloating
7. Breast discharge and tenderness
8. Spotty darkening of the skin
9. Skin rash
10. Depression
11. Tiredness
12. Dizziness
13. Loss of hair from head
14. Increase in growth of body hair
15. Vaginal dryness
16. Change in sex drive
17. Change in blood pressure
How effective is it . . . 99.7%
If a woman has her first injection during the first five days of her period, Depo Provera is effective immediately. If not, she should use a back up method of birth control for 2-3 weeks after the injection.
Where to get it . . .
The injection needs to be given in a clinic or hospital by a doctor or nurse. Sexual Health Centre Saskatoon sells Depo Provera and has a nurse inject it after a consultation with the nurse and doctor. The cost of the injection at Sexual Health Centre Saskatoon is $15. Because Depo Provera often causes loss or lightening of menstrual bleeding, it is recommended that women do a pregnancy test prior to each injection.
Important: Potential Effect of DEPO-PROVERA on Bone Mineral Density (BMD) Changes in Adults and Adolescents
Pfizer Canada Inc. would like to inform you of important updated safety information, currently under evaluation by Health Canada for Depo-Provera indicated for the prevention of pregnancy in women of child-bearing potential and treatment of endometriosis. As a result of new clinical studies, one with adults and one with adolescents, we now have clinical data regarding the use of Depo-Provera and its associated effect on BMD. The data suggest that women who use Depo-Provera may lose significant BMD. Bone loss is greater with increasing duration and may not be completely reversible. It is unknown if use of Depo-Provera during adolescence or early adulthood, a critical period of bone accretion, will reduce peak bone mass and increase the risk of osteoporatic fracture in later life.
Pfizer is currently working in collaboration with Health Canada to revise the Product Monograph. The proposed update to the Depo-Provera labeling will affect the following section:
INDICATIONS and CLINICAL USE: Addition of a Risk-Benefit statement stating that loss of BMD in women of all ages, and the impact on peak bone mass in adolescents, should be considered, along with decrease in BMD that occurs during pregnancy and/or lactation, for women who use Depo-Provera long term
WARNINGS: Addition of statements regarding loss of BMD in adults and adolescent females
DOSAGE and ADMINISTRATION: Addition of a cautionary statement about the use of Depo-Provera in adolescence and early adulthood
ADVERSE REACTIONS: Addition of a statement based on post-marketing experience regarding rare cases of osteoporosis including osteoporotic fractures reported