Do you have a period on depo

What is Depo Provera and how does it work?

Depo Provera is a long acting form of birth control and is used to treat irregular periods (menstrual irregularities). It is given by injection (a shot) into the muscle. It is slowly released over 3 months. It has a female hormone (progestin) and works by stopping the release of an egg each month.

Depo Provera follow up

You must go back to the clinic 12 weeks after you get your shot of Depo Provera. This appointment will be with a nurse. The nurse will only be able to give you the next shot.

If you want to change to a different birth control, please call the clinic at 1-319-356-2294 for an appointment with a doctor.

You will see your doctor at your yearly exam. You should have yearly exams for your routine health care.

How is Depo Provera used?

The shots are given in the hip once every 12 weeks.

They may be given earlier than 12 weeks if you cannot make your next appointment at the scheduled time.

Do not have a shot more than 1 week late or you could become pregnant.

How well does Depo Provera work?

Less than 1% of users become pregnant during the first year of use. This means it works as well as birth control pills or getting your tubes tied.

Pros

• Ease of use
  • You get a shot at 3 months instead of taking a pill each day or using something each time you have sex.
• It works well if you get your shots on time. 
  • If the first shot is given during your period, the birth control works within 24 hours.
  • If you are not having your period, a pregnancy test will be done and you must use a backup method of birth control for 3 weeks.
• You can become pregnant again after stopping the shots.
• It can be used by women who cannot take estrogen, the hormone in most birth control pills.
• Studies have shown that there is no greater risk for breast, ovarian, liver, or cervical cancer. It lowers the risk of cancer of the uterus.
• It is safe to use while breastfeeding. 
  • It will not change the quantity or quality of milk.
  • It will not harm the baby.
  • The shot can be given in the first few days after childbirth.

Cons

• You can have irregular bleeding (mostly spotting) in the first year of use. The bleeding lessens over time. After 1 year, half of the women using this method will stop having periods.
• Some women have had loss of bone mineral density. For most women, this bone density loss is partially or totally replaced after stopping. Women with known osteoporosis should have periodic assessment of their bone density while on it.
• Weight gain
  • Women may gain 5 to 10 pounds. This happens most often for women who eat high fat diets and/or who do not exercise.
• Fertility may take a while to come back after the shots are stopped. Most women who want to become pregnant will become pregnant within 6 to 8 months after the last shot. It rarely may take longer than a year.
• It does not protect against sexually transmitted infections (STIs). Condom use is to lower your risk of infections.
• Rare side effects are:
  • Headaches
  • Feeling nervous
  • Lowered sex drive
  • Dizziness
  • Fatigue
  • Breast tenderness

Who should not take Depo Provera?

• If you are pregnant or think you might be pregnant.
• If you have irregular vaginal bleeding that has not been checked health care provider.
• If you have certain types of liver disease.
• If you have had breast cancer.

Depo-Provera (medroxyprogesterone acetate) is a form of birth control. It is an injection, or shot, that contains progestin. This is a natural hormone that your ovaries produce each month as part of your menstrual cycle. You must get it from your primary care or women’s doctor. They give you the injection in either your upper arm or buttock. It can go into a muscle (intramuscular) or under your skin (subcutaneous).

Depo-Provera prevents pregnancy by stopping ovulation (the release of an egg by your ovaries). It thickens your cervical mucus, which makes it hard for sperm to reach and fertilize an egg. It also thins your uterine lining, which makes it hard for a fertilized egg to implant, or attach, to your uterus.

Path to improved health

Depo-Provera works for about 3 months at a time. To prevent pregnancy, you have to get 1 shot from your doctor 4 times a year, about 12 to 14 weeks apart. If you get it in the first 7 days of your cycle, it works right away. If you don’t, you’ll need to use another form of birth control for 1 week. Your doctor will confirm you are not pregnant before giving you the injection.

Most women who use Depo-Provera have changes in their menstrual periods. These may include:

• Bleeding or spotting between menstrual periods.
• An increase or decrease in menstrual bleeding.
• No menstrual bleeding at all.

About half of women who use Depo-Provera stop having periods after 1 year. This is not harmful. Menstrual bleeding usually returns to normal when you stop using Depo-Provera. It may take about 9 to 10 months to get pregnant after your last shot.

Contact your doctor right away if you have abnormally heavy or nonstop bleeding. Other possible side effects of Depo-Provera include:

• weight gain
• headaches
• nervousness
• abdominal pain
• dizziness
• weakness or fatigue
• osteoporosis (loss of bone density)
• blood clots
• chance of an ectopic pregnancy (when a pregnancy is located outside of the uterus)

Things to consider

Due to an increased risk of osteoporosis, you should limit the use of Depo-Provera to 2 years. Eat foods high in vitamin D and calcium to increase your bone density. Depo-Provera may increase your chance of having breast cancer if you begin using it before the age of 35.

Women who are breastfeeding can use Depo-Provera. You should not use it if you are pregnant, trying to get pregnant, or have:

• Uncontrolled high blood pressure.
• Heart, kidney, or liver disease.
• Breast cancer.
• A history of heart attack or stroke.
• Unknown vaginal bleeding.
• An allergy to the drug in Depo-Provera.

Depo-Provera is effective at preventing pregnancy if you get the shots on time. The success rate is more than 99%. It is as effective as having a tubal ligation (getting your “tubes tied”). The success rate can be higher than other forms of birth control, including diaphragms, condoms, and pills. Depo-Provera does not protect against sexually transmitted diseases (STDs). You and/or your partner still should use condoms to prevent getting an STD.

Questions to ask your doctor

• How do I know if Depo-Provera is right for me, or if I should use another form of birth control?
• Does my age play a factor in using Depo-Provera?
• How long can I take Depo-Provera?
• Does my insurance cover Depo-Provera?

Resources

National Institutes of Health, MedlinePlus: Medroxyprogesterone Injection

U.S. Food and Drug Administration, Birth Control: Medicines to Help You

Copyright © American Academy of Family Physicians

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.

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