The form of progestin that is most commonly used is DMPA (depot medroxy progesterone acetate), which is distributed under the name Depo-Provera. This is injected into the buttocks or upper arm. Another version, called depo-subQ provera 104, is injected into tissue just under the skin. It contains less progestin but is equally effective.
The injection method appeals to women who don't want the hassle of taking a daily pill, or can’t take oestrogen, or do not want to use an IUD. The shot can complicate conception for about a year after you stop using it. As with the Pill, it only prevents pregnancy, not STD's or HIV.
The shot works by introducing long-lasting progestin into your body, which suppresses ovulation. It also thicken cervical mucus, so that even if you ovulate, sperm cells have a difficult time reaching the fallopian tubes. Progestin also causes the lining of your uterus to thin, making it difficult for a fertilized egg to attach itself there.
This method of contraception can be used while breastfeeding. It is advisable to wait at least six weeks after delivery to start the course of injections. Although more of the progestin enters into your milk via the injection, than via the progestin-only pill, there is no evidence of side effects for nursing babies. Some mothers find that the progestin-only pill affects milk production. It is therefore a good idea to try the progestin-only pill when you are breastfeeding, to see if your milk production is affected, before using the injection.
The injection is said to be 99.7 percent effective, if it is administered correctly and at the correct intervals. Most of the conceptions that happen for women on the shot are due to skipped or late appointments.
If you plan on becoming pregnant after using the injection for any length of time, you need to stop the injection for at least a year before you can expect to become pregnant. You will know when you are fertile again by the onset of regular periods. If your periods do not start after a year of being off the injection, consult a doctor. Schedule a preconception check up a few months prior to trying to conceive and take folic acid at least a month before trying. Your doctor or healthcare provider can give you the shot. Do not rub the immediate area around the injection because this will affect the performance of the progestin.
If you start with the shot after you have had a baby, it is possible to get your first injection before you leave the hospital. This is only advisable if you are not breastfeeding. If you are breastfeeding, you should wait six weeks. (You should not be having sex the first 6 six after giving birth so this should not be an issue). It is possible for your body to ovulate during the first month of getting the shot, so you should rely on another method of contraception for the first month of getting the injection.
If you neglect to get your scheduled shot on time, you have about a week's leeway to do so. If you are late for your injection, it is best to use an alternative contraceptive method as a backup, such as condoms.
There are health benefits to having the injection. There is less blood loss during periods and many women cease having periods at all after a year of being on the injection. Less blood loss means less iron is lost. This is of benefit to women who are already anaemic. PMS sufferers experience less-severe symptoms after being on the injection. The risk of ovarian cancer is lowered, symptoms of endometriosis are lessened and the frequency of sickle cell crises is reduced amongst women suffering from sickle cell disease.
Unpredictable periods can be a side effect of the injection, with vaginal bleeding happening between periods. Eventually this stops, after about three months. Periods also cease after a year or two of continued injections. Some women report significant weight gain after starting the injections, while others report no big difference. Appetite can increase, but weight gain and diet habits are subjective. Some women complain about headaches, vaginal dryness, dizziness, rashes and tender breasts. While some women experience increased anxiety on the injection, others find their anxiety is reduced.
The main health risk from the shot is reduced bone density due to the declining levels of oestrogen. The longer you are on the injection, the greater the loss is of bone density. It is advisable to use an alternate method of contraception after two continuous years of the injection. The effects can be reversed, if the progestin injections are used for less than two years. In the unlikely event that you do get pregnant while on the shot, there is a much higher chance of your pregnancy being ectopic – which is life-threatening. Be aware of this and get any abdominal pain checked out by your doctor. In very rare cases, women experience bad allergic reactions to the progestin. Your doctor ought to let you wait in the office for at least 20 minutes after administering the injection for the first time. Let your doctor know if there is any itching around the site of the injection over the days that follow.
Your doctor should do a patient history to ascertain whether you have risk factors before taking the shot. The injection is unsuitable for the following cases; if you have had a heart attack, stroke, or suffer from heart disease, or high blood pressure; you have had liver disease, such as hepatitis; you experience vaginal bleeding for an unexplained reason; you have had a blood clot; you plan on conceiving within a year.
These symptoms are indicative of serious problems, should you experience any of them you need to contact your doctor; headaches that are severe, or are getting worse; depression; unusually heavy bleeding from the vagina; jaundice; pain or tenderness in your lower abdomen or pelvis.