Review on Depo-provera Injection

Depo-Provera is a brand name for Medroxyprogesterone acetate, a female contraceptive injection that contains progestin hormone. Ideally called the injection or DP, it was approved in 1992 by the Federal Drug Administration as a type of contraception (Shoup, 2012). The progesterone in the infusion is similar to that produced naturally in a woman’s reproductive system. The contraceptive once administered leaves a deposit of medroxyprogesterone which is released gradually over a 12 week period for prevention of pregnancy. And It is highly efficient, long-lasting requires little adherence. How the Method is used The first dose of 150mg Depo-Provera is administered through a deep intramuscular injection into the Gluteus Maximus muscle using a Z-track method (Depo-Provera, 2018). It works the same way to the implant, as it slowly releases progesterone hormone into the bloodstream. It is given the first five days of the menstrual cycle for immediate contraceptive effect; Even though giving it later than this will require an additional method for at least seven days, but the injection is then repeated after twelve weeks, and at this time must be administered before five days.

After delivery, the person can have the injection as soon as five days postpartum if not breastfeeding. However, this can lead to prolonged bleeding. Thus patients need counseling before administration of the DP. On the other hand, if the injection interval exceeds 12 weeks and five days, a pregnancy test has to be carried out first, and after administration, the patient has to use additional contraceptive for 14 days. Again, when a patient is switching to another hormonal contraception, they have to work on a regime that works for them. It means that if using oral pills and changing to the DP, the injection should be administered within seven days after taking the last active pill. Women that are concerned with Depo-Provera require counseling from a doctor on potential adverse effects which include bleeding irregularities, weight gain, bone mineral density, and delayed return to fertility. How it prevents Pregnancy The DP prevents conception in three significant ways.

The first is by stopping the ovary from releasing an egg every month to prevent ovulation. It inhibits ovulation by lowering the level of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) and eliminating the LH surge (Hampton, 2013). Suppression of FSC causes the concomitant destruction of estradiol and estrone production in the ovaries (Perry 2014). Some other processes include thickening of the natural cervical mucus; making the endometrium less receptive to implantation and make sure to limit the activity of cilia in the fallopian tube.

Adverse Effects One of the most effects of Depo-Provera is weight gain which affects about 1% of patients. A woman may experience about 2.25-3.5kg weight gain in the first one or two years of use (PR, 2013). The weight increases with prolonged use; As a result, users should consider weight management to manage their weight. The injection also causes menstrual changes which include Amenorrhoea or heavy bleeding and spotting. With that being said, practicing nurses should note that Depo-Provera lowers estrogen levels, which leads to loss of BMD. They should, therefore, maintain great caution on adolescents and young women below 21 years because they may have immature bones, and regularly re-evaluating the risks and benefits. A study demonstrated that women between 21 to 51 years who used Depo-Provera for five years had reduced bone density in Lumbar spine and the femoral neck especially those whose family has a history of osteoporosis (PR, 2013). However, when it’s stopped being used, the bone density returns to normal. Some short-term adverse effects are headaches, abdominal bloating, breast tenderness, and mood changes plus reduced libido. Unique Advantages When it’s correctly used, the DP is 99% effective, meaning less than one person in 100 who use the contraceptive injection becomes pregnant in a year (Mumuni, 2014).

Again, because it lasts for several weeks, there will be no strain of thinking about contraceptives every time one wants to have sex. It is, therefore, a good method for women who easily forget to take the daily contraceptive pill. Besides, the contraceptive injection provides limited protection against ovarian cancer and pelvic inflammatory disease because the thickened mucus in the cervix can stop bacteria from entering the womb (Perry 2014). It is also not affected by other medications and does not interrupt sex. The injection is also a suitable choice for those who cannot use estrogen-based contraceptives such as the combined pill, patch, or vaginal ring. The injection at times reduces heavy and painful menstruation and aids with premenstrual symptoms in some women. Protection from STI Women who use Depo-Provera are at a higher risk of getting sexually transmitted diseases. They are more likely to acquire chlamydia or gonorrhea in a one year course compared to those who birth control pills or non-hormonal contraceptives. In fact, about 150 million cases of chlamydia and gonorrhea are reported globally every year and are responsible for conditions such as infertility and pelvic inflammatory disease (PR 2013). Due to this, sexually active women with more than one sexual partner should use condoms consistently. They can also reduce the number of partners to lower the risk of STI. The injection acts by stopping the ovaries from releasing eggs thus protecting against pregnancy. This, however, does not protect against reproductive tract infections. The injectable contraceptive decreases estrogen levels thus leading to susceptibility to vaginal and cervical infections. Women should, therefore, consider using condoms along-side the contraceptive injection for double protection against pregnancy and sexually transmitted diseases.

Cost and Where it can be Obtained Most contraceptives are available in most general principal surgeries, community contraception clinics, and genitourinary medicine (GUM) clinics. It is easy to get the birth control shot as one can also get it from sexual health clinics which offer contraceptives and STI testing services. Its cost mostly depends on the place where you live and the health insurance. In cases where one needs an exam before the shot, there may be additional costs, and can approximately cost between $0-$250 (Varney, 2015).

The good thing is with the Affordable Care Act; one gets a cover for birth control for free. Contraception services are also given for free even for those with no insurance covers depending on their income and legal status in the U.S. They may qualify for other programs like Medicaid and local programs that can help pay for birth control. How to Bring up the Topic with a New Partner Taking charge of your sexuality is very healthy and partners should discuss methods of birth control to find one that works for them, and learn how to efficiently and consistently use it. It can start with having a conversation over dinner, or on the phone, or during a sex discussion before hitting the sheets. You can share what you like, and discuss protection preference which will actually boost the intimate adventure as the partners feel comfortable and connected.

The woman should be the first to raise the contraception topic with a new partner on the first date. Getting intimate with a new person is always nervous and bringing up the birth control topic may add up the tension. It is therefore many ways to bring it up before getting intimate with your partner. In conclusion, women should take charge of their sexuality. They should understand that apart from birth control, they need to get protection from sexually transmitted infections. The contraception injection is an effective method of preventing pregnancy but should be backed up with condoms to protect against STI and HIV/Aids.