Long-Acting Progestin Birth Control
Depo-Provera has been produced in the United States since 1969 but was not approved as a method of contraception until 1992. DMPA is a very safe and well-studied method of contraception whose major advantages are that it contains no estrogen and can be administered only 4 times a year eliminating some of the compliance issues associated with pills, patches and rings.
How does it work?
Depo-Provera works primarily by inhibiting ovulation. It also causes thinning of the uterine lining (endometrium) and thickening of the cervical mucus causing it to be less penetrable by sperm.
There are several non-contraceptive benefits of DMPA which include a decreased risk of endometrial cancer and pelvic inflammatory disease. Women who receive DMPA generally become amenorrheic (stop having their menstrual periods). Some women, especially those that have had a history of heavy and painful periods, select DMPA for this benefit alone.
Another non-contraceptive benefit of DMPA lay in its ability to reduce pain that may be caused by endometriosis. DMPA, in fact, is one of the oldest effective medical treatments for endometriosis.
Depo-Provera is only available as an injectable method of contraception. Some women can be taught to self-inject every three months—most, however, will require a visit to a health care provider.
- Return to fertility is delayed—after discontinuing Depo-Provera it may take 6-10 months after the last injection to begin ovulation again making it possible to conceive.
- Irregular bleeding—most women taking Depo-Provera will stop having periods entirely (amenorrhea). Some women experience light but continuous spotting or bleeding. This is an uncommon but very annoying side effect.
- Weight gain—there is considerable debate about whether or not DMPA causes weight gain. Most controlled studies show its use is not associated with weight gain. However, many women do associate its use with considerable weight gain. Unfortunately, the vast majority of these women continue to gain weight long after discontinuing the use of DMPA suggesting that something else is at play.
- Bone loss—the prolonged use of DMPA may contribute to bone loss in some women. Women who are at risk for osteoporosis (click here) should be aware of this problem and may request testing for osteopenia or osteoporosis.