Depo Provera: A primer

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Q: Does Depo-Provera lead to permanent infertility? 

Short A: Nope.

Long A:  Depo Provera (“Depo,” “the Shot”) is one of a family of progesterone-only contraceptive products. It is an injectable product-a shot. It is a really effective and convenient way to prevent pregnancy; you only have to think about it 4 times a year and in clinical studies, less than 1% of women get pregnant on it.  (In real life, about 5% get pregnant – probably because in real-life some women didn’t get their shot on time.)

There are a couple of downsides to Depo Provera. It is, as noted, a shot. Ouch. It can be expensive if your insurance doesn’t cover contraception. (On the other hand, a baby is a whole lot more expensive!) Like most hormonal contraceptive products (say that three times fast), some women will feel a little bit pregnant-bloated, queasy, weight changes, headachy-on Depo, especially at first. Some women gain up to 5-10 pounds on Depo, although most gain only 3-5 pounds. (While 3-5 pounds ain’t nothin’ it’s still a whole lot less than a baby!)  It can interfere with bone mineralization, making osteoporosis and fractures slightly more likely down the road.

There are some big upsides, though, too. Periods often stop, although for the first few weeks/months of use there can be some irregular spotting. (Are all you men out there going, yuck, gross, icky?)  The incidence of pelvic inflammatory disease, endometrial hyperplasia, endometrial cancer, and endometriosis pain are all decreased.  And there are also specific medical conditions which benefit from Depo-Provera:

  • Because the metabolism of Depo Provera doesn’t change with anti-seizure medicine, it’s a good choice for women with seizure disorders.
  • Women with sickle cell disease appear to have fewer pain crises while on depo. 
  • Peri-menopausal vasomotor symptoms (the dreaded “hot flashes“) tend to be better compared to birth control that has estrogen in it.    

Depo Provera does not appear to increase the risk of liver, breast, or ovarian cancers. It probably does not affect blood pressure or coagulation, making it sometimes an okay choice for women who have had high blood pressure, heart disease, or a history of blood clots. It unfortunately does not protect women from sexually transmitted infections so you still need to get a condom on your partner.

So to finally answer your question, Depo Provera does not permanently impair your ability to get pregnant. It can, though, take a few months off the medication (sometimes up to 18) to become pregnant.

And by the way, if you are pregnant and accidentally get the shot, there is no evidence to suggest that any harm will come to the baby as a result of the medicine.

Victoria Rentel, MD (OSU SHS)

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