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Depo-Provera, a contraception drug, is a synthetic hormone (progestin), which is injected under the skin. It is 95-99% effective in preventing pregnancy for 3 months. For continued protection against pregnancy, women must return every 3 months for another injection. Each time a shot is given, a high level of progestin is released into the body. This unnaturally high level stops the natural production of both progesterone and estrogen. As a result, the ovary does not prepare an egg and the lining of the uterus is not prepared to support a fertilized egg. In addition, the cervix (opening to the uterus) secretes mucus that blocks sperm from entering the uterus.

If you are interested in using Depo-Provera for contraception, you should understand the following:

There is no antidote that reverses the effects of Depo-Provera. You will have to wait before the effects of the drug eventually wear off as the levels of the drug slowly decline. Sometimes the unpleasant side effects last for several months after the last shot. Most women will not resume regular menstrual cycles right away. On the average, it takes ten months after the last shot before women are fertile again. Some women have not been able to get pregnant. Many women suffer from depression while taking Depo-Provera. Medical professionals may not recognize this strong connection and encourage women on Depo to also take anti-depressant drugs, instead of suggesting the woman stop taking Depo-Provera.

Studies of the risk of cancer in women using Depo-Provera have been conducted in other countries. The most disturbing results have been in the breast cancer studies. Three studies on Depo-Provera, found an increase in the risk of breast cancer in women less than 35 years old. These studies are not yet conclusive. Many scientists discount the increased risk for young women because they did not find an overall increased risk of breast cancer for all women exposed to Depo-Provera. We remain concerned about this possible risk. Long- term use of Depo-Provera may be the most likely to increase the risk of cancer, but very few long-term users were included in the studies.

Depo-Provera use may decrease the amount of calcium in your bones. The longer you are on Depo-Provera the more calcium you may lose. This increases the risk of your bones weakening if you use Depo-Provera continuously for a long time (for more than 2 years). The calcium may not return completely once you stop using Depo-Provera. The loss of calcium may increase your risk of osteoporosis and broken bones, particularly after your menopause. The decrease of calcium in your bones is of most concern if you are a teenager, young adult, or have the following risk factors:

Taking calcium and vitamin D may lessen the loss of calcium from your bones. It is recommended that you stop using Depo-Provera after 2 years. If you want to switch birth control, Women's Health Specialists can give you information about other methods.

FDA and Upjohn (the manufacturer of Depo-Provera) agree that women should not use Depo-Provera if they have ever experienced any of the following health problems: acute liver disease; breast cancer; blood clots in the legs, lungs or eyes; or any current unexplained vaginal bleeding.

There have been instances in this country and other countries where women have been pressured into using Depo-Provera or have been given the shot without understanding what it was. Only you as a woman can decide what the best method of birth control is for you.