What is Depot meldroxyprogesterone acetate?
Also known as Depo-Provera™ and Depo-Ravolera™ it contains a long-acting hormonal contraception called medroxyprogesterone, which is similar to the female hormone progesterone.
How is it given?
By injection by a doctor or nurse every 12 weeks.
How does it work?
- Stops ovulation
- Thickens the mucus at the entrance to the uterus (cervix) so that the sperm cannot get through to fertilise the egg
- Alters the lining of the uterus so any fertilised egg will not implant and grow.
Does it work?
"Depo" is almost 100 percent effective.
It should be started within 3 days of a period starting, for immediate protection. If Depo-Provera is started at any other time in your cycle, it is best to use another form of contraception for seven days.
The injections wear off after 12 weeks and there is a leeway of one week after that. If you have not had another injection in that time, it is advised that you use other forms of contraception.
What are the advantages?
- Does not interfere with sexual intercourse
- Can help to reduce endometriosis (thickening of the lining of the uterus)
- Helps reduce the incidence of uterine cancer
- Reduces the risk of thrush and pelvic inflammatory disease (an infection that can lead to infertility)
- Can be used by women who are unable to use contraception that contains oestrogen.
What are the disadvantages/side effects?
There are concerns that a woman may harm her baby by taking "Depo" when she does not realise that she is pregnant. To date, however, no serious foetal abnormalities due to the drug have been reported.
Side effects may include:
- Weight gain
- Irregular bleeding
- No bleeding
- Loss of libido
- A delay in return to fertility with 60 percent of women pregnant within twelve months after stopping the drug, and 90 percent pregnant within two years.
- The main problem is that, if a side effect does occur, it may well last for the duration of the injection which is twelve weeks.
- Some evidence indicates that Depo-Provera may cause thinning of the bones. This is believed to be reversible, once the injections have stopped. Thinning of bones is of concern for young women who have been menstruating for less than three years. This period is a critical time for young women to build up their bone strength for the years ahead.
Research shows that "Depo" is significantly associated with a loss of bone mass while using the method, particularly with long term use (longer than two years), and has received a black box warning in the USA. This indicates that women and doctors, considering using or prescribing "Depo", should consider the serious side effects associated with this drug and consider alternative contraceptive choices first.
Research also indicates:
- Bone mass loss is probably reversible if women stop taking Depo.
- For young women who may not have put down their maximum stores of calcium and should still be increasing bone mass, there is a possible increase in the risk of osteoporosis in later life.
It is important to maintain bone mass through diet and exercise regardless of age of the woman using "Depo".