From the Guidelines
Depo-Provera (medroxyprogesterone acetate) injections can be started at any age after the onset of menstruation, with most healthcare providers prescribing it for adolescents and women from age 12 through menopause, as long as the provider is reasonably certain the patient is not pregnant 1.
Key Considerations
- The shot is administered every 12-13 weeks (about 3 months) as a 150 mg intramuscular injection, usually in the arm or buttock.
- Before starting Depo-Provera, a healthcare provider will evaluate medical history, particularly focusing on risk factors for osteoporosis, as the medication can cause temporary bone mineral density loss 1.
- No pregnancy test is required before the first injection if it's given within the first 5 days of a normal menstrual period, but a backup method of contraception should be used for at least the first week 1.
- For adolescents, parental consent requirements vary by location, though many jurisdictions allow minors to consent to contraceptive care independently.
Mechanism and Efficacy
- Depo-Provera works by suppressing ovulation, thickening cervical mucus, and thinning the uterine lining, providing effective contraception with a failure rate of less than 1% when used correctly 1.
- Common side effects include irregular bleeding, weight gain, and headaches, which should be discussed with a healthcare provider before starting treatment 1.
Important Recommendations
- Patients receiving DMPA injections should be counseled about age-appropriate recommendations for supplementation with calcium and vitamin D and regular weight-bearing exercise to maintain skeletal health 1.
- A backup method of contraception, such as condoms, should be used for at least the first week after starting Depo-Provera to ensure contraceptive efficacy 1.
From the Research
Depo-Provera Shots
- The Depo-Provera shot, also known as medroxyprogesterone acetate, is a highly effective contraceptive method that can be administered to women of reproductive age 2, 3.
- According to the studies, there is no specific minimum age requirement mentioned for getting Depo-Provera shots, but the studies involve women between 18 and 40 years of age 4, 5.
- The American College of Obstetricians and Gynecologists (ACOG) recommends that adolescents be counseled about all forms of contraception, including Depo-Provera, but does not specify a minimum age for its use.
- It is essential to note that Depo-Provera should only be administered to women who are not pregnant, as fetal exposure may lead to low birth weight and other problems 2.
- Women under 18 years old can use Depo-Provera, but it is crucial to ensure they receive proper counseling and understand the potential side effects and benefits of the method.
Initiating Depo-Provera
- Traditional protocols for Depo-Provera initiation recommend starting the method during the first 5-7 days of the menstrual cycle 6.
- However, an alternative approach is to give women the injection immediately during the clinic visit, regardless of menstrual cycle day, to ensure they are protected from pregnancy as soon as possible 6.
- A study on immediate initiation of Depo-Provera found that 92% of subjects returned for a follow-up pregnancy test, and 47% continued to a second DMPA injection or another contraceptive method within 14 weeks of their initial clinic visit 6.
Important Considerations
- Women should be informed about the potential side effects of Depo-Provera, including menstrual irregularities, weight gain, and osteoporosis 2, 3.
- It is crucial to provide accurate and easily understood patient information leaflets to address any concerns or misconceptions about the method 3.
- Healthcare providers should ensure that women receive proper counseling and follow-up care to minimize the risk of side effects and ensure the effectiveness of the method.