Can a 13-year-old use the Depo-Provera (medroxyprogesterone) shot?

From the Guidelines

The Depo-Provera shot can be used in 13-year-old adolescents, but it should only be prescribed after careful consideration by a healthcare provider, taking into account the potential benefits and risks, including effects on bone mineral density and weight gain, as noted in studies such as 1 and 1. When considering the use of Depo-Provera in adolescents, it is essential to weigh the benefits against the potential risks. The benefits include highly effective contraception, reduced menstrual cramps, and no need for daily medication adherence. However, potential side effects like irregular bleeding, weight gain, and concerns about bone mineral density in developing adolescents must be carefully considered.

• The standard dose is 150 mg injected into a muscle every 12-13 weeks, as stated in 1.
• For adolescents, the benefits include highly effective contraception (over 99% effective when used correctly) and reduced menstrual cramps.
• However, there are important considerations, including potential side effects like irregular bleeding, weight gain, and concerns about bone mineral density in developing adolescents, as discussed in 1 and 1.
• The first injection should be given within the first 5 days of the menstrual cycle or with a negative pregnancy test, as recommended in 1.
• A healthcare provider should discuss all contraceptive options, considering the adolescent's medical history, lifestyle, and preferences before making this decision, as emphasized in 1.
• Regular follow-up appointments are essential to monitor for side effects and ensure timely repeat injections, as noted in 1.

From the FDA Drug Label

Medroxyprogesterone Acetate Injectable Suspension, USP is not indicated before menarche. BMD Changes in Adolescent Females (12–18 years of age) In adolescents, interpretation of BMD results should take into account patient age and skeletal maturity Other than concerns about loss of BMD, the safety and effectiveness are expected to be the same for postmenarchal adolescents and adult women.

The Medroxyprogesterone Acetate Injectable Suspension, USP can be used in 13-year-old females who have reached menarche. However, it is crucial to consider the potential risks, particularly the loss of Bone Mineral Density (BMD), and weigh these against the benefits of using this contraceptive method.

• The decision to use Medroxyprogesterone Acetate Injectable Suspension, USP in a 13-year-old should be made on a case-by-case basis, taking into account the individual's overall health, medical history, and skeletal maturity.
• It is essential to monitor BMD and address any concerns or potential side effects promptly.
• Patients should be informed about the risks and benefits associated with the use of Medroxyprogesterone Acetate Injectable Suspension, USP, as compared with other forms of contraception or with no contraception at all 2 2.

From the Research

Use of Depo Shot in 13-Year-Olds

• The Depo-Provera shot, also known as depot medroxyprogesterone acetate (DMPA), is a highly effective and safe contraceptive method for adolescents, including 13-year-olds 3, 4.
• According to the study published in Pediatrics in 2001, DMPA is one of the safe and effective contraceptive methods available for adolescents 3.
• The American journal of obstetrics and gynecology study in 1994 states that DMPA has a contraceptive efficacy exceeding 99% and is a highly effective, safe, convenient, and reversible contraceptive option for appropriately selected patients 5.
• However, the use of DMPA in adolescents has been associated with concerns about bone density loss, particularly with long-term use 6.
• A study published in The Journal of adolescent health in 1995 examined the effects of an early second injection or prior oral contraception on side effects of Depo-Provera in adolescents and found that early administration of the second injection did not alter the bleeding episodes, but was associated with excessive weight gain 7.

Safety and Efficacy

• The Depo-Provera shot is considered safe for use in adolescents, including 13-year-olds, but it is essential to weigh the benefits and risks, particularly regarding bone density loss 4, 6.
• The efficacy of DMPA in preventing pregnancy is high, exceeding 99%, making it a reliable contraceptive method for adolescents 5.

Considerations for Use

• Healthcare providers should consider the individual needs and circumstances of each adolescent before prescribing the Depo-Provera shot 4.
• It is crucial to discuss the potential side effects, including menstrual changes, weight gain, and bone density loss, with the adolescent and their parents or guardians before initiating DMPA use 5, 6, 7.