Depo Provera

What is depo provera shot?

Depo provera is a birth controlling process which is applicable in women. The mechanism of action of this process is similar to the progesterone hormone. The composition of the depo povera is sterile water base medroxyprogesterone acetate. Though this is effective in oral and parenteral route, but preferably, it is given via intra muscular injection.

The site of the shots is in the arm or buttocks. After stopping the shots of the depo povera, usually after 2-3 months, women become a pregnant. But in some cases it will take time almost more than year or two. The time variation is totally depends upon individual to individual and unrelated to duration of dose taken.

Depo provera calendar

Depo provera drug should not be taken without medical consultation. Before starting the initial dose of the depo provera shot, it is necessary to confirm that individual patient is not a pregnant.

The initial dose of the drug is started within five days of the menstrual cycle. After child delivery, if breast feeding is not continued, then doctors recommend this shot within five days of the child birth for contraception. In case of breast feeding mothers, after six weeks of the child delivery, the depo provera shot is recommended. If initial dose is differ from this, and then it is always advisable that pregnancy test should conduct before commence the shot.

The duration of effect of each shot lasts for 12 to 14 weeks, but for obtain the full protection it is advisable to take the next shot after 12 weeks, the will manipulate after 13 weeks, but before commence the shot, pregnancy test should conduct.

Preparation and instruction for providing injection

To clean the injection site, alcohol swab is used.
It is advisable do not massage the site of injection after administration.
Doctors usually suggested that after first administration of the injection, continuation of taking the contraceptive pills for 7 days as precautionary measure.

Mechanism of action of Depo provera shot

The active constituent of Depo-Provera formulation is medroxyprogesterone acetate. The action of medroxyprogesterone acetate is similar with progesterone, as it is derivative of progesterone.

Medroxyprogesterone acetate is bioavailable after administration of oral and parenteral route. This is prescribed for women who have endogenous estrogen. The prescribed dose of the Depo-Provera hinders secretions of gonadotropin from anterior pituitary gland which is responsible for follicular maturation and ovulation. Hence lessen the secretion leads to prevention of follicular maturation and ovulation.

Benefits of depo provera shots

There is no chance of missing the daily dose before intercourse, so need not to remember or dose missing tension is negligible.
Prolonged effectiveness. After a dose administration after three months the next dose will be.
High efficacy
Cost effective than regular contraceptive pills

Effectiveness

The effectiveness to avert pregnancy is almost 99%.

Side effects

The included side effects of Depo-Provera,

Missing of menstrual cycle or total stoppage of the periods
Headache
Palpitation
Mental depression
Vertigo
Pimples
Modified appetite
Increase weight
Excessive hair growth in body or facial region
Hair fall
Low bone density

Among these side effects, the most common is alteration of menstrual cycle or irregular menstrual cycle. After continuous use of Depo-provera for one year, it quite common that almost half of the female is having cessation of menstrual cycle. This condition is reversible means after stoppage of Depo-provera shots again the menstrual cycle is started.

Prolong usage of Depo-Provera shots almost for two years, may causes osteoporosis, due to defeat of bone mineral density. Increase alcohol consumption, smoking, family history enhance the risk of onset of osteoporosis.

Contraindications

Depo-provera shot is safe for almost every woman. But the following are the conditions when doctors are not recommended Depo-provera shot:

Inexplicable vaginal bleeding
Hepatic diseases
Cerbro-vascular disease
Hypersensitivity
Breast cancer
Thrombophlebitis or other blood coagulation disorder such as thromboembolic disorders
Osteoporosis

When Depo-provera shot should discontinue?

After providing the first shot, doctors should be alert of the onset of any thrombophlebitis disorders. If this happen, then immediate stoppage of the drug is needed.
Onset of retino-vascular lesions lead to diplopia, partial vision loss need immediate discontinuation of the Depo-provera shot.

How long time is required to become a pregnant after stopping the shots?

Usual time to become a pregnant after last Depo-provera shot is 3 to 4 months. It is also reported that some female wait for 2 or more years to become pregnant after stopping of the Depo-provera shot.

Recommendations

It is recommended that avoid using multi dose vial, as the chances of contamination is increased. If multi dose vial is used, then proper aseptic technique should use.

Precautionary measures

The women who regularly use Depo-provera shots, following regular physical examinations need for precautionary measures:

Breast cancer

Any medical or family history of breast cancer needs regular physical examination due to hormonal misbalance.

Accumulation of fluid

The derivatives of progesterone hormone cause accumulation of fluids and may cause onset of migraine, epilepsy, asthma, renal and cardiac dysfunction.

Vaginal bleeding

Irregular vaginal bleeding, if occurs need to consider it for further diagnosis.

Mental Depression

The individual having tendency to become mentally depressed or having history of depression need regular check up to prevent recurrence of the condition.

Breast feeding

Evidence shows that the some amount of drug from Depo-provera shots is excreted via breast milk, so precaution should be taken for nursing mother.

Drug Interactions

Concomitant use of Aminoglutethimide with Depo-provera causes decrease efficacy of the Depo-provera. The drug interaction between Aminoglutethimide with Depo-provera leads to decrease serum concentration level.

Cost (in USD)

Expense for each month of Depo-provera shots is 20USD. Some insurance companies partially cover this expense. Discount is also provided by some of the clinics or hospitals.

References

http://www.webmd.com/sex/birth-control/birth-control-depo-provera
http://www.drugs.com/pro/depo-provera.html
Depo-Provera (Medroxyprogesterone) Drug at http://www.rxlist.com/depo-provera-drug.htm
http://www.mayoclinic.org/tests-procedures/depo-provera/basics/what-you-can-expect/prc-20013801
Depo-Provera – Birth Control Shot – Planned Parenthood at https://www.plannedparenthood.org/learn/birth-control/birth-control-shot-depo-provera
STI – Birth Control Shot (Depo-Provera) – Cost at http://www.med.nyu.edu/sti/content0033.html?cid=5