Page 10: DepoProvera® (DMPA)

Now let's talk about projestin-only contraception.

DMPA is an injectable progestin only form of birth control. The injection is given every 13 weeks. DMPA provides a continuous, reversible method of birth control. Consider the following information when selecting DMPA as a method of birth control.

  • Prevents ovulation (release of the egg from the ovary) and causes changes in cervical mucus.
  • Is long acting and stays in the body for prolonged period of time Even when the injections have been discontinued, it may take several months for regular periods to return.
  • Fertility (the ability to become pregnant) may be delayed for 12-18 months after discontinuing injections. However, you may become pregnant right away.
  • Injections must be received every 11-15 weeks. If an injection is not received within 15 weeks, you must immediately begin using an alternate form of birth control. A pregnancy test will be required before another injection is given.
  • All women taking DMPA should be sure to get 1000-1200 mg of calcium per day in their diet or by taking a calcium supplement that also contains vitamin D.

 

Risks related to DepoProvera®

  • Women who use DMPA may lose significant bone mineral density. Bone loss is greater with increasing duration of use and may not be completely reversible.
  • Adolescence or early adulthood is a critical time for the body to build bone mass. It is unknown if Depo Provera® use during this developmental time will increase the risk of osteoporosis and related bone fractures later in life.
  • Women who have chronic alcohol or tobacco use, very low body weight, a family history of osteoporosis, or who regularly take certain drugs known to contribute to reduced bone mass (i.e. anticonvulsant medications, corticosteroids) are at greater risk of developing osteoporosis. If you have any of these medical conditions, it is important to talk with your medical provider.
  • Use of DepoProvera® may cause symptoms of significant mental depression. Women who have had previous problems with depression or bi-polar disorder may not be good candidates to use DMPA.
  • Women who have a history of irregular periods may not be good candidates for DMPA.
  • Effects of the medication may continue for several months even when injections have been discontinued.

 

Side effects

  • CHANGES IN BLEEDING PATTERNS: amount of bleeding may vary from irregular, unpredictable spotting to no bleeding at all. A few women may experience daily spotting.
  • WEIGHT GAIN may occur. Appetite may increase.
  • HEADACHES may occur. Contact your provider if they are severe, occur daily or don’t respond to over-the-counter medication.

 

Effectiveness

DepoProvera® is 99.5% effective when injections are received on schedule.

 

To Start DMPA

  • Schedule a screening appointment with an MD or Advanced Practice Nurse by calling the Women’s Health Department at 217-244-2501.
  • Available at McKinley Health Center for an additional charge.

 

 

Progestin-Only Pill (POP)

Progestin-only pill is an option for women in whom an estrogen-containing contraceptive is either contra-indicated or causes additional health concerns. The progestin-only pill works in the following ways:

  • Inconsistent suppression of ovulation
  • Thickens cervical mucous
  • Thins the lining of the uterus

 

Consider the following when selecting the progestin-only pill as a method of birth control.

  • Start the pill on the first day of the period
  • Back up birth control is not necessary if POPs are started within the first five days of the start of the period. When POPs are started at other times in the cycle, a back-up method is needed for seven days.
  • Due to short action of the POP it is essential that the pill be taken at the same time each day to maximize effectiveness. Even if taken a few hours late, a back-up method of birth control is recommended.
  • POPs are not as effective as Combined Hormonal Contraception in preventing pregnancy. Typical use failure rate is estimated to be over 8 percent.

 

Side Effects

  • Unscheduled bleeding and spotting are the most common side effects