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Birth control pills can be annoying to every woman taking them; they must taken every day at the same time in order to be fully effective, and missing a pill could leave a woman doubtful of their reliability if she is sexually active.
An easy answer to this dilemma might be to change to Depo-Provera, the shot form of birth control. However, before a woman makes this change, it is important to understand the advantages of this method of birth control and the disadvantages.
Depo-Provera, more commonly known Depo, uses a man-made form of the female hormone progesterone, which is a hormone used to prevent the development of an embryo or fetus. The Depo shot injects a high level of this hormone into a woman’s body to prevent her ovaries from releasing an egg. A woman must receive a shot of Depo every three months (12 weeks) either in her upper arm or buttocks, in order for it to be fully effective.
“In the big picture of becoming pregnant, Depo is better for people that are not going to remember to take their pill daily,” said Jane Jordan, a licensed practical nurse for the Adolescent and Family Institute.
Jordan, who works with adolescent woman on a day-to-day basis, said she believes Depo-Provera is good for adolescent girls because the protection is still there but the responsibility to take a pill everyday is not.
According to Medscape, protection against pregnancy starts 24 hours after a woman receives the Depo-Provera shot and provides protection against pregnancy for up to 14 weeks. But it is important to note, a shot must be injected every 12 weeks by her physician to remain fully protected.
Some women opt for Depo-Provera because it does not contain the female hormone estrogen, which birth control pills do. Estrogen, in the pills, can cause cardiovascular problems according to an article by McKesson Health Solutions, LLC.
“Depo-Provera is recommended for women with a medical history of high blood pressure; women with a history of blood clots or women who experience frequent migraines because estrogen can increase these problems. Also good candidates for Depo are young patients because they are so high risk for forgetting to take their pills,” Sandra Gonzalez, a physician assistant at Rocky Mountain Pediatrics, said.
Gonzalez also said this form of birth control is a better solution for smokers.
“I would recommend this form of birth control also to smokers because if a woman is on the pill she has an increased risk of blood clots,” Gonzalez said.
Depo-Provera is proven to be over 99 percent effective and is less expensive than the pill, but it does not protect a woman against STD’s. It does however provide long-term protection from pregnancy as long as the woman gets the shot every three months.
The following side effects, however, have been linked to women while using Depo-Provera: weight gain, headaches, nervousness, abdominal or back pain, breast pain, weakness, dizziness, acne, decreased sex drive, depression, nausea, loss of calcium in bones, increased risk for osteoporosis and broken bones, irregular bleeding or spotting and changes in the menstrual cycle.
“While on Depo-Provera, it is common for women not to have their menstrual cycle at all. In some cases, women have received it once a year or not at all. But for other women, they could experience spotting for as long as six months,” Gonzalez said.
Having irregular bleeding while on Depo-Provera is a common side effect, but it depends from woman to woman how long it occurs or how bad the spotting is.
Although there are risks for every kind of birth control, what seems to be of major concern for users of Depo-Provera is the significant loss in bone-mineral density.
Gonzalez said she believes bone density loss is a very serious issue women must face.
“In your teenage years you lay down the amount of bone mass you are going to have for the rest of life. So when you are 50 and are in need of some more bone mass, you might be hurting. I’m not sure if it (bone density) goes up at all later on life,” Gonzalez said.
Zosia Chustecka said on Medscape that because of this side effect, a Black label warning on Depo-Provera was issued in 2004 as a result of studies that began in 1990. The studies were carried out among women between 25-35 years of age and adolescents. The results showed a significant loss in bone-mineral density from the contraceptive.
“The bone loss is greater with increasing duration of use and may not be completely reversible,” Chustecka said on Medscape.
After this finding, it was advised for women who are currently on Depo-Provera, or who plan on using it as their form of birth control, to not use it for longer than two years. The exact amount of bone-mineral loss at any given period of time while on Depo-Provera is unknown, but health care providers may suggest another form of birth control or bone density tests if a woman wants to stay on birth control.
“I have seen (loss of bone density) in my practice and it is a big threat,” Gonzalez said.
Once a woman begins the process of Depo-Provera and wishes to end it, it takes an estimated three to four months for the hormones to get out of a woman’s system after her last shot. A side effect that might occur with some women is not being able to conceive a child for one to two years after stopping the doses of Depo-Provera. This amount of time of infertility however, seems to have no relationship to how long a woman was on Depo-Provera.
In another case, according to Medscape, breast density decreased for some women while on Depo-Provera, which may increase the risk of breast cancer. It is advised that women should not use Depo-Provera if they have breast cancer or a history of breast cancer in their family.
Another side effect could be weight gain and lack of sex drive.
“My friend was on Depo back in high school and she gained weight and had a severe loss in her sex drive, which was weird because that was why she got in it, to protect herself so she could have sex,” Meghan Brannick, a senior psychology major, said.
Brannick said she would never want to be on Depo-Provera because it has too many side effects, regardless of how annoying it is to take a pill everyday.
“It is 99 percent effective, yes, but you have a whole litany of other problems that come with it. I don’t necessarily think it is bad for younger girls or girls who will forget, but I personally would not use it,” Brannick said.
If you have any further questions please consult your health care provider.
Contact Campus Press staff writer Elizabeth Stortroen at firstname.lastname@example.org.