|What Is The Birth Control Shot?
It is an injection containing the hormone progestin that is taken every 3 months to prevent pregnancy. It is also known under the brand name Depo-Provera or by the name of the drug in the injection, DMPA (depot medroxyprogesterone acetate). The first injectable contraception was called Lunelle, it contained a low dose of both estrogen and progestin but needed to be taken once a month. It was recalled in 2002 and replaced with Depo-Provera. Like birth control implants Implanon and Nexplanon, Depo-Provera only contains progestin, it does not contain estrogen.
How Much Does Depo-Provera Cost?
A typical shot ends up costing about $50 to $60 every 3 months.
How Does It Work?
The injection prevents pregnancy in several ways:
1. By suppressing ovulation: If no egg is released an embryo cannot form.
2. Increases the thickness of the cervical mucus making it more difficult for sperm to reach the fallopian tubes.
3. Alters the lining of the womb making it more difficult for an embryo to implant.
How Effective Is It In Preventing Pregnancy?
It is highly effective. Less than 1 percent of women will become pregnant each year if they take the shot as directed. In practice this doesn't always happen, and about 3 in every 100 become pregnant. Don't forget however that the shot does not protect against sexually transmitted diseases like syphilis, herpes, gonorrhea or AIDs, a condom or female condom will help reduce this risk. You will need to take a Depo-Provera shot every 12 weeks. If you are more than a week late in getting your injection, your doctor may ask you take a pregnancy test before giving you the injection. Or he may advise you to take emergency contraception if you have had intercourse within the previous 5 days (120 hours).
How Do I Get The Injection?
You should contact your doctor to arrange an appointment for the shot. If you get the injection within the first 5 days of the start of your period, it is effective 24 hours later. If you are injected at any other time in your menstrual cycle you need to use an extra form of contraception (such as contraceptive diaphragm or condom) for the first 7 days.
There are two types of Depo-Provera injections - the difference being that one contains a lower dosage of DMPA. The low dose version is called Depo-subQ Provera 104. While the original shot is injected deep into the muscle, the lower dose version is injected just beneath the skin. While they both have similar benefits and risks, there are fewer long-term studies about the effectiveness of Depo-subQ Provera 104.
When Should I Start Treatment?
First Time: If you are using it as a contraceptive for the first time, the first injection should ONLY be given within the first 5 days of your period.
Postpartum: If you are using it postpartum, after the birth of your baby and are NOT breastfeeding, you should receive the injection within 5 days of childbirth. If you are breastfeeding it should be given 6 weeks after childbirth.
Switching: If you are switching from the oral contraceptive pill you should have the shot within 7 days of taking the last active pill in the packet.
Miscarriage: If you had a miscarriage or abortion procedure you should take the shot within 5 days.
If for any reason you do not have the injection at the correct time you will need to use a backup form of birth control for the first 7 days (like a diaphragm, condom or contraceptive sponge).
Will It Affect My Periods?
For the first 6 to 12 months you may find your periods become irregular. Spotting between periods, heavy periods or missed periods are not uncommon. If your periods become very heavy or do not stop, talk to your doctor. After 12 months (4 injections) nearly 60 percent of women stop having periods altogether. This increases to nearly 70 percent after 24 months. This is not considered harmful.
When Is Depo-Provera Recommended?
Your doctor may recommend Depo-Provera as a method of contraception if you:
• Don't want to take a birth control pill every day.
• Want or need to avoid using estrogen for health reasons (effects of estrogen).
• Are breastfeeding. Shots do not contain estrogen which can affect milk supply.
• As a treatment for endometriosis or uterine fibroids.
• It does not require daily attention.
• It is known to reduce symptoms of PMS such as menstrual cramps and pain.
• Reduces the risk of endometrial cancer and pelvic inflammatory disease.
• It is sometimes used in the treatment of cancer including endometrial, breast and kidney cancer. It works by inhibiting the growth of cancer cells.
On the cons side:
• Not everyone is comfortable with regular injections.
• It does not protect against STDs. In fact some studies suggest that hormone contraceptives increase a woman's risk of catching the HIV virus (the cause of AIDs). If you are concerned about AIDs you should use a condom.
• If you are under 35 at the time of your first injection, you may have a slightly increased risk of developing breast cancer. This is similar to the risk with the Pill. Read, Is it safe to take the contraceptive pill after 35?
• It can decrease the amount of calcium stored in your bones, raising your osteoporosis risk factors in later life.
Potential side effects include:
• Tummy pain
• Breast soreness
• Reduced libido
• Irregular periods and spotting
• Reduced bone mineral density which may not be completely reversible
• Weakness and fatigue
• Weight gain
It Is Not Suitable:
If you are pregnant or have:
• Unexplained vaginal bleeding - get it checked first.
• Breast cancer.
• Liver disease.
• A history of blood-clotting problems.
• Fragility fractures associated with brittle bones (osteoporosis).
• Taking the medication aminoglutethamide to treat Cushing's syndrome.
• Be sure to tell your doctor if you have a history of heart disease, stroke, depression or if you have diabetes.
When To Call A Doctor
Call your doctor if you:
• Become severely depressed.
• Develop heavy periods.
• Have a severe lower tummy pain.
• Have a persistent pain in your leg which may be a sign of a blood clot.
• Develop sudden sharp chest pain, shortness of breath or if you cough up blood (blood clot in lungs).
• Develop sudden partial or complete blindness (blood clot in the eye).
• Show signs of jaundice, yellowing of the skin and whites of the eyes.
• Develop severe and sudden headaches.
How Long Will It Take To Get Pregnant After?
When you stop taking Depo-Provera it can take up to 10 months before you start ovulating again. If you wish to become pregnant within the next one to two years another type of contraceptive may be more suitable.