Glossary

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  • Depot-Provera (Depot Medroxy Progesterone Acetate)
    • A contraceptive administered via intramuscular injection every three months.
    • Works by inhibiting ovulation. It will also make cervical mucus much thicker and thin the uterine lining.
    • Efficacy is as reliable as sterilization.
    • As indicated by its name, it is progesterone only and may be an ideal contraceptive choice for patients who experience estrogen side effects with combined oral contraceptive pills (OCP) or patients who canít remember to take the OCP.
    • It will not decrease breast milk supply and is ideal for breastfeeding patients. Ideal in patients with sickle cell disease and seizure disorder.
    • Ideal for patients with thrombophilias. (Genetic risk of clotting, that is, Factor 5 leidon mutation). Even though current package inserts inappropriately label a history of venous thromboembolism as a contraindication for its use.
    • Problems with Depot-Provera:
      • Irregular menstrual bleeding: twenty-five percent discontinue use in first year for this reason. Irregular bleeding occurs in 70 percent in the first year and 10 percent thereafter.
      • Weight gain: it is an appetite stimulant, and patients who donít control their calorie intake will gain weight.
      • Reversible loss of bone density: bone loss is similar to the loss seen with lactating women. To date, not associated with increases in osteoporosis or fractures.
      • Prolonged return to fertility: it may take 8 months to a year to return to normal cycling.
      • Depression: patients prone to depression may suffer an exacerbation on Depot-Provera.
    • Sources:
      • Speroff L, Glass R, Kase N. Long-Acting Methods of Contraception. Clinical Gynecologic Endocrinology and Infertility. Lippincott, Williams and Wilkins. Baltimore 6th ed. Pp. 963-968
      • The Use of Hormonal Contraception in Women with Coexisting Medical Conditions. ACOG Practice Bulletin. ACOG. Washington DC. #18, July, 2000.
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