Provera side effects
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Side Effects of Depo-Provera: A Comprehensive Review
Introduction to Depo-Provera Side Effects
Depo-Provera, a long-acting injectable contraceptive, is widely used for its high efficacy in preventing pregnancy. However, its use is associated with various side effects that can impact user continuation rates and overall health. This article synthesizes findings from multiple studies to provide a clear understanding of the side effects associated with Depo-Provera.
Menstrual Irregularities and Bleeding Patterns
One of the most commonly reported side effects of Depo-Provera is menstrual irregularities. Studies have consistently shown that users experience spotting, prolonged bleeding, and amenorrhea. In a multicenter trial in China, spotting and prolonged bleeding were the main reasons for discontinuation, although these complaints decreased over time while amenorrhea increased. Similarly, in Sri Lanka, about one-third of users became amenorrheic, and a quarter experienced spotting and irregular bleeding. These findings are echoed in a review that noted a significant proportion of users experience disturbed bleeding patterns, including irregular and occasionally heavy bleeding.
Weight Gain
Weight gain is another frequently observed side effect of Depo-Provera. In a study involving Nigerian women, excessive weight gain was a major reason for discontinuation. This was supported by findings from a study on adolescents, where significant BMI increases were noted, particularly when the second injection was administered early. Additionally, a review highlighted weight gain as a common side effect, further corroborating these findings.
Other Physiological Side Effects
Depo-Provera use has been linked to various other physiological side effects. In Sri Lanka, users reported side effects such as vomiting, headache, and dizziness, although these declined over time. A study on adolescents also noted that prior use of oral contraceptives did not alter the rate of BMI gain but did reduce the duration of bleeding episodes. Furthermore, a review mentioned that Depo-Provera might induce a diabetogenic stress of moderate magnitude, although the development of clinical diabetes is rare.
Impact on Blood Lipids
Alterations in blood lipid profiles have been observed in Depo-Provera users. A study on Nigerian women found reduced levels of fasting plasma cholesterol but higher fasting plasma triglyceride levels compared to controls. This suggests that Depo-Provera may have complex effects on lipid metabolism, which warrants further investigation.
Psychological and Behavioral Effects
Psychological and behavioral effects have also been reported. In a study on the treatment of genital exhibitionism, Provera (Medroxyprogesterone) was found to significantly reduce serum testosterone levels, although it did not consistently affect reported sexual behavior changes or side effects at dosages of 100 to 150 mg.
Continuation Rates and Reasons for Discontinuation
Continuation rates for Depo-Provera vary, with many users discontinuing due to side effects. In a study involving Chinese women, the cumulative continuation rate was 72.87%. In Sri Lanka, continuation rates were 58% at 12 months and 29% at 24 months, with older and higher parity women showing lower continuation rates. Among adolescents in New York City, continuation rates were 71% at 3 months, 48% at 6 months, and 27% at 12 months, with side effects such as menstrual irregularities and weight gain being primary reasons for discontinuation.
Conclusion
Depo-Provera is an effective contraceptive method, but its use is associated with various side effects, including menstrual irregularities, weight gain, and other physiological changes. These side effects significantly impact user continuation rates. Understanding these side effects can help healthcare providers offer better counseling and support to users, potentially improving continuation rates and overall satisfaction with Depo-Provera.
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