Depo-Provera Overview

Depo-Provera is an injectable contraceptive that helps prevent pregnancy. Depo-Provera is part of a class of medications called "progestins." It works by preventing ovulation (the release of eggs from the ovaries) and thinning the uterine lining. The U.S. Food and Drug Administration (FDA) approved Depo-Provera in 1992.

Pfizer manufactures Depo-Provera (depot medroxyprogesterone acetate). There is a generic version of the drug, medroxyprogesterone acetate injectable. Millions of women in the United States take this drug to prevent pregnancy.

Depo-Provera is a birth control drug. It does not prevent the spread of human immunodeficiency virus (HIV) or other sexually transmitted diseases (STDs). Nor does it help prevent sexually transmitted infections (STIs).

This article will describe the adverse side effects of Depo-Provera. It will also discuss which patients should avoid taking this medication.

What To Do Before Using Depo-Provera

Depo-Provera is not for everyone. The birth control shot treats women who want to avoid pregnancy. Pregnant women should not take this medication. The same is true for people looking to become pregnant.

Before taking this medication, meet with your gynecologist and primary care physician. When you first meet to discuss taking this drug, your doctor will administer a pregnancy test. You will also undergo a pap smear and physical exam.

According to a study in the National Library of Medicine, taking Depo-Provera while pregnant does not necessarily increase your risk of miscarriage or congenital disabilities. But, it is not a risk worth taking.

Assuming everything is fine, your health care provider will administer the shot to your upper arm or buttocks. The shot is subcutaneous, which means the injection goes between the skin and muscles. You may experience minor pain at the injection site.

Your Doctor Will Monitor Your Use of Depo-Provera

A health care provider usually administers your first injection of Depo-Provera in their office or clinic. Before your first shot, work with your provider to ensure that there's no possibility of pregnancy.

Women taking another form of birth control must also work closely with their health care provider to determine when to start taking Depo-Provera. This is true when scheduling your next injection as well.

Your menstrual cycle will probably change after you start using Depo-Provera. Women commonly experience irregular periods and spotting while using the drug. These changes are a natural result of the medication and should disappear once you stop taking the drug.

Depo-Provera is a long-term birth control solution. This makes it a unique form of contraception. It may take a while to become pregnant after your last shot with the typical use of Depo-Provera. Your health care professional can offer advice on how Depo-Provera can affect near-term plans to become pregnant.

Patients taking Depo-Provera should undergo a complete physical at least once a year. This should include measuring blood pressure, a breast and pelvic examination, and a pap test.

Patients should also regularly monitor their breasts and immediately report any lumps. Also, if you undergo any laboratory tests, you should inform the relevant personnel that you are taking Depo-Provera.

Side Effects of Depo-Provera

As with hormonal contraceptives, Depo-Provera has minor and severe side effects. Weigh these possible side effects against the benefits before taking the drug.

The common side effects of Depo-Provera include:

• Changes in menstrual periods
• Weight gain
• Heavy bleeding
• Irritability
• Depression
• Difficulty falling asleep or staying asleep
• Hot flashes
• Breast pain, swelling, or tenderness
• Stomach cramps or bloating
• Back or joint pain
• Loss of hair on the scalp
• Swelling, redness, irritation, burning, or itching of the vagina
• Changes in sexual desire
• Cold or flu symptoms

Other less common but potentially severe side effects include:

• Sudden shortness of breath
• Sudden sharp or crushing chest pain
• Coughing up blood
• Severe headache
• Upset stomach
• Vomiting
• Dizziness or faintness
• Change or loss of vision
• Double vision
• Bulging eyes
• Difficulty speaking
• Weakness or numbness in an arm or leg
• Seizure
• Yellowing of the skin or eyes
• Extreme tiredness
• Pain, swelling, warmth, redness, or tenderness in one leg only
• Difficulty breathing or swallowing
• Swelling of the hands, feet, ankles, or lower legs

If you experience several of these symptoms, let your doctor know. You may want to consider switching to a birth control pill, IUD, or other method of birth control. It all comes down to the severity of your side effects.

Depo-Provera Health Risks

Besides the side effects, taking Depo-Provera poses other health risks. Women under 35 who began taking the drug may face a slightly higher risk of developing breast cancer.

Patients also risk developing blood clots, which can potentially lead to a pulmonary embolism or stroke. The doctor prescribing this medication will discuss these risk factors with you.

People Who Should Avoid Taking Depo-Provera

Patients who have a history of breast cancer or who have breast cancer shouldn't take Depo-Provera. Even if a patient suspects they may have breast cancer, they shouldn't take an injection of this contraceptive.

Other patients who should avoid taking Depo-Provera include the following:

• Patients who've had a stroke
• Patients with endometriosis
• Patients who've had a blood clot in their lungs or limbs
• Patients who have liver problems or liver disease
• Patients who have unexplained vaginal bleeding

Your doctor will examine you before prescribing Depo-Provera. If they discover any of these conditions, they'll suggest an alternative form of birth control.

Special Dietary Instructions

Patients taking Depo-Provera should consume foods containing calcium and Vitamin D. This helps prevent a calcium deficiency in the bones. Some patients choose to take calcium and Vitamin D supplements instead. A health care provider or nutritionist could help you adjust your diet.

Depo-Provera FDA Alert

In November 2004, the FDA announced that Pfizer would add a black box warning to its Depo-Provera Contraceptive Injection label. The label warns Depo-Provera users that long-term use may cause loss of bone density.

The warning also says a woman should only use Depo-Provera as a long-term birth control method if other birth control methods prove inadequate.

Besides the black box warning, Depo-Provera manufacturer Pfizer issued a "Dear Healthcare Professional" letter about the effect of long-term treatment on bone mineral density. This letter also included new information in the patient information sheet distributed with Depo-Provera.

Depo-Provera and Other Medical Complications

Like other drugs, Depo-Provera may cause various medical complications. Minor complications include weight gain, headaches, and irregular menstrual cycles. Often, Depo-Provera patients will stop having menstrual periods. In other cases, patients may have spotting or irregular bleeding.

Major complications associated with Depo-Provera include bone density loss and allergic reactions. If a patient becomes pregnant while taking Depo-Provera or experiences stabbing abdominal pain, their doctor must examine them for a possible ectopic pregnancy.

Manufacturers Can Be Liable for Injuries

Like other drugs, Depo-Provera must meet patient safety standards. Under product liability law, manufacturers and sellers must ensure their products are safe and defect-free. This applies to the manufacturers of drugs like Depro-Provera.

Contraceptives must not contain product defects such as manufacturing defects, defective warnings, and design defects. If a drug manufacturer or seller markets an unreasonably dangerous or defective contraceptive, it can be liable for any resulting injuries.

For example, if a patient took a contraceptive and became ill, they could sue the drug manufacturer. If they win, the court will award them damages.

These damages may include:

• Medical bills and future medical expenses
• Lost wages and lost future income
• Pain and suffering
• Emotional distress
• Punitive damages

Courts rarely award punitive damages in this type of case. Punitive damages punish defendants for egregious conduct. It will be challenging to prove that the manufacturer of Depo-Provera intentionally marketed a dangerous product.

Your Doctor May Also Be Liable for Your Injuries

Doctors owe their patients a duty of care. When they treat a patient, that treatment must meet specific standards. If your health care is subpar and harms you, the courts may hold your doctor liable for medical malpractice.

For example, if a doctor inadvertently injects Depo-Provera into a breast cancer patient and the patient later suffers injuries, the doctor may be liable for medical malpractice.

Talk to an Attorney About Your Depo-Provera Claim

If you had the Depo-Provera shot and are now sick, you may have a legal claim. The best way to know is to meet with an experienced product liability attorney.