FACT SHEET: Depo-Provera® Depot-medroxyprogesterone Acetate (DMPA) 150mg (“The Shot”, “Depo”)
Before using Depo-Provera®, you need to know the advantages, disadvantages, risks, and warning signs to watch for. This fact sheet, along with the individualized education provided by our staff represents your informed consent for this method. You will also be given the FDA approved manufacturer’s information. You are encouraged to read this information. A Nurse Practitioner is always available to answer any questions you may have.
Depo-Provera® is a progesterone only method of birth control. The synthetic hormone DMPA (depot- medroxyprogestrone acetate) works by preventing ovulation (the release of the egg from the ovary), thickening cervical mucus, and thinning the lining of the uterus. Depo is given as a shot. BENEFITS: • 99% effective when used correctly (getting the shot on time); • Long acting: the shot is given every 12 weeks (4 times per year); • May be a good method for women who can’t use estrogen. RISKS: You should not use Depo if: • You are or suspect that you may be pregnant; • You have unexplained vaginal bleeding;
• You have breast cancer now or in the past; • You are allergic to DMPA; • You are taking the drug Aminogluthethamide (for Cushing’s Syndrome). Talk to your Nurse Practitioner if you have: • Diabetes, high cholesterol or triglycerides, high blood pressure;
• Headaches, seizures, depression; • Kidney disease, gall bladder disease; • A family history of breast cancer or you are currently breast feeding. WARNING SIGNS: • Sudden severe headache;
• Sharp chest pain; • Severe lower abdominal pain; • Severe pain or swelling in the calf; • Redness, swelling, or pain at the injection site. Possible Minor Side Effects: Menstrual Changes: All women experience irregular bleeding on DMPA. During the first year, bleeding and spotting can be more frequent than the typical once a month period. Over time, bleeding typically becomes less frequent. Many women stop bleeding altogether. This is an expected and normal side effect of DMPA. Weight Gain: About two-thirds of women gain weight while using DMPA. It may be possible to avoid weight gain by exercising regularly and by carefully monitoring your caloric intake. Other Possible Side Effects: Headaches, mood changes, depression, acne, hair loss, change in sex drive, vaginal dryness. GETTING STARTED: Your first Depo shot will be given within the first five (5) days of your next menstrual cycle. Or, if you are already on a hormonal method, schedule your first shot during the withdrawal week. Occasionally, a Nurse Practitioner will determine a start-up plan that is best for you and your situation. In all cases, however, an accurate negative pregnancy test must be done prior to starting on Depo. The Injection: The shot is given into the muscle either in the upper arm or the upper outer part of the buttocks. To Continue on DMPA: Your next shot will be due in twelve (12) weeks. You will be given a reminder card with the date your next shot is due. You are responsible for calling and scheduling your next shot. Don’t miss your next shot! If you do miss your scheduled shot, use another method of birth control until you get restarted. DMPA AND FUTURE PREGNANCY After DMPA is stopped, it may take months for a woman to start ovulating again. It is impossible to know how long it will take for you to become pregnant after your last shot. Every woman is different. The length of time you use DMPA makes no difference either. You should consider this delay when planning a pregnancy. To discontinue DMPA, do not receive your next injection. If you don’t plan to be pregnant, use a different method of birth control. If you are planning to become pregnant start taking 400mcg of Folic Acid. Folic Acid is important in preventing certain birth defects in babies. SPECIAL CONSIDERATION: BONE DENSITY AND DMPA* Women who use DMPA have temporary decrease in bone mineral density (BMD). This decrease seems to be the greatest in the first two years of use. While these studies show that BMD decreases, none of the studies addressed the key issue of whether the decreased BMD increases future risk of a fracture. Three recent studies have shown that BMD losses recover after DMPA is stopped. You are balancing your very real risk of pregnancy versus short-term decrease in BMD. All women need to pay attention to bone health. So we recommend the following: Daily weight bearing exercise, limit your alcohol intake, and if you smoke STOP. Take 1300mg of calcium, plus 400IU of Vitamin D daily. *FDA insert has a Black Box warning.
Client signature: ________________________________________________________Date: _____________ I witness that the client received this information, said she read and understood it, and had an opportunity to ask questions. Witness signature: ______________________________________________________Date: _____________
Address: 1201 Caledonia Street, La Crosse, WI 54603
Administration: 608.775.8380 Clinic: 608.775.8390 Fax: 608.775.8385 Website: www.optionsclinic.org
US DHHS, OPA, OFP: Title X Family Planning Program
CMI3410 – Competing in the digital economy Osterwalder, A. & Pigneur, Y. (2004), An ontology for e-business models in Currie, W. (ed.) "Value Creation from E-Business Models” (2004), Butterworth-Heinemann (M. Pullar’s Restructure) I have set the pages as landscape so the restructured model on page 2 fits with as little text wrapping as possible to keep the hierarchical stru