Side effects from provera
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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 effectiveness in preventing pregnancy. However, its use is associated with various side effects that can impact users' health and continuation rates. This article synthesizes findings from multiple studies to provide a clear understanding of the side effects associated with Depo-Provera.
Common Side Effects: Weight Gain and Menstrual Irregularities
Weight Gain
One of the most frequently reported side effects of Depo-Provera is weight gain. Studies have shown that a significant proportion of users experience an increase in body weight during the course of treatment. For instance, a study conducted in Nigeria found that excessive weight gain was a major reason for discontinuation of Depo-Provera therapy1. Similarly, research involving adolescents indicated that early administration of the second injection predisposed users to greater weight gain4. Another study noted that 41-66% of women appeared to gain weight over the observation period3.
Menstrual Irregularities
Menstrual disturbances are another common side effect. These include spotting, prolonged bleeding, and amenorrhea. A multicentered clinical trial in China reported that spotting, prolonged bleeding, and amenorrhea were the main reasons for discontinuation2. In Sri Lanka, about one-third of women continuing with Depo-Provera became amenorrheic, and a quarter experienced menstrual disturbances such as spotting and irregular bleeding3. Adolescents also reported menstrual irregularities, with many discontinuing due to irregular bleeding after just one injection10.
Other Reported Side Effects
Headaches, Dizziness, and Vomiting
In addition to weight gain and menstrual irregularities, other side effects such as headaches, dizziness, and vomiting have been reported. A study in Sri Lanka found that 6% of women experienced these side effects following the first dose, although the incidence declined over time3.
Blood Lipid Alterations
Depo-Provera has been shown to affect blood lipid profiles. Research in Nigeria indicated that users had reduced levels of fasting plasma cholesterol but higher fasting plasma triglyceride levels compared to controls1.
Impact on Blood Pressure
Interestingly, a study in China found no significant adverse effects on weight and blood pressure among Depo-Provera users2. This suggests that while some side effects are common, others may not be universally experienced.
Serious Health Concerns
Carcinogenic Potential
The potential carcinogenic effects of Depo-Provera have been a topic of debate. Initial tests on laboratory animals indicated an increased incidence of mammary carcinoma, leading to concerns about its safety6. However, subsequent studies, including a 12-year WHO multinational study, reassured that the risk of breast cancer did not increase with the duration of use8. Despite this, the debate on its carcinogenic potential continues, with no conclusive evidence linking Depo-Provera to an increased risk of cervical cancer9.
Other Health Risks
Other serious health risks associated with Depo-Provera include interference with carbohydrate metabolism, suppression of immune responses, and potential diabetogenic stress6 9. These effects underscore the need for careful monitoring and consideration when prescribing Depo-Provera.
Conclusion
Depo-Provera is an effective contraceptive method with a range of side effects that can impact user experience and continuation rates. Common side effects include weight gain and menstrual irregularities, while more serious health concerns such as potential carcinogenic effects and metabolic disturbances warrant further investigation. Understanding these side effects is crucial for healthcare providers to offer appropriate counseling and support to users, ensuring informed decision-making and better management of side effects.
Sources and full results
Most relevant research papers on this topic
Alterations in blood lipids and side effects induced by depo-provera in Nigerian women.
Depo-provera reduces fasting plasma cholesterol but may cause weight gain and irregular bleeding, with side effects varying depending on the duration of effective therapy.
Observational StudyA multicentered clinical trial of the long-acting injectable contraceptive Depo Provera in Chinese women.
Depo Provera is an effective contraceptive method with high acceptability and continuation rates, especially suitable for lactating Chinese women.
Non-RCT
Large Human TrialDepo-Provera use in Sri Lanka: acceptor characteristics, continuation and side effects.
Depo-Provera has played a significant role in Sri Lanka by providing desired pregnancy spacing and allowing couples time to decide to stop having children and get sterilized without fear of pregnancy.
Observational StudyDepo-Provera in adolescents: effects of early second injection or prior oral contraception.
Early second Depo-Provera injection does not alter menstrual abnormalities and predisposes to greater weight gain, while prior oral contraceptive use reduces bleeding duration without changing weight gain rate.
Non-RCTThe effect of assertiveness training, Provera and sex of therapist in the treatment of genital exhibitionism.
Provera combined with assertion therapy may increase drop-out rates and recidivism in male genital exhibitionists, suggesting its limited effectiveness in treating genital exhibitionism.
RCT
Highly CitedDepo-Provera: a critical analysis.
Depo-Provera has serious side effects, including endometrial carcinoma, shortened life expectancy, and increased risk of congenital malformations in children, and its continued contraceptive use is questionable due to these findings.
Depo-provera: contraceptive risk?
Depo-provera is a safer and more effective contraceptive method than oral contraceptives, with no statistically valid evidence linking it to breast or cervical cancer.
Update on Depo-Provera [editorial]
Depo-Provera is an effective and safe contraceptive with no serious side effects, and should be available in both developed and developing countries for women who need protection against pregnancy.
Depo Provera: a review.
Depo Provera effectively reduces pregnancy rates, but may cause weight gain, irregular bleeding, and delayed menstruation.
Literature ReviewLong-term depot medroxyprogesterone acetate (Depo-Provera) use in inner-city adolescents.
Depo-Provera continuation rates among adolescents are low, but over a third may restart the method due to side effects and appointment noncompliance, warranting close follow-up.
Observational StudyHighly Cited