Depo Provera/ Non-Preg Injection

by Dr. Wong Mann Ru (07.02.2025)

Depo-Provera contains the hormone progestin- medroxyprogesterone acetate, used as a form of contraception that acts primarily by suppression of ovulation, preventing the ovaries from releasing an egg. It also thickens cervical mucus to prevent sperm penetration.

How is Depo-Provera given?

It is administered by intramsucular injection in the deltoid or buttock muscle every three months or twelve weeks. It should be given during the first 5 days of your normal monthly period. If  it were to be given after 5 days of your normal period, additional contraception (eg. wearing a condom) or abstinence is required for 7 days. If the time between your injections is greater than 14 weeks, you might need a pregnancy test before another injection.

Who is eligible for the injection?

It is generally safe for most people EXCEPT in conditions:

  1. Unexplained vaginal bleeding
  2. Suspected or current breast cancer
  3. Severe liver impairment
  4. Known hypersensitivity to medroxyprogesterone acetate or any component of the drug
  5. Current or history of blood clots, heart disease or stroke

Advantages:

  1. No daily pill taking/daily compliance needed 
  2. Cost effective
  3. Decrease risk of endometrial cancer
  4. Reduces menstrual pain and cramps 
  5. Safe for breastfeeding women
  6. Lighter periods

Disadvantages:

1.It might cause thinning of bones (risk of loss of bone marrow density), but this usually improves after discontinuation. There is no evidence of  long term fracture risk.

  1. It may take some time (up to 1 year) to regain your fertility after discontinuation.
  2. Irregular periods may occur, especially during the first 3 months of use.
  3. Does not protect against sexually transmitted disease.

Some possible side effects:

  1. Weight changes
  2. Headache
  3. Abdominal pain or discomfort
  4. Dizziness
  5. Nausea

Warnings:

-It is advisable for users who wish to continue using Depo-Provera injection more than 2 years to have at least 2 yearly review by a healthcare professional in view of the risk of reduction in bone marrow density. Bone marrow density should be evaluated, benefits and potential risks should be discussed depending on each individual’s condition. 

-If you are planning to conceive in the next few months, it’s best not to use Depo Provera. 

-Use of Depo Provera may continue up to age of 50 years. If you are more than 50 years old, It is better to choose other types of contraception methods. 

 

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