From the Guidelines
Depo-Provera (medroxyprogesterone acetate) should be administered as a 150 mg intramuscular injection every 12 weeks (3 months) for contraception, with the option of a subcutaneous formulation (Depo-SubQ Provera 104) given at 104 mg every 12-14 weeks. The dose and administration schedule are crucial for maintaining contraceptive effectiveness, as supported by studies such as 1 and 1. It is essential to note that the first injection should be given within the first 5 days of a normal menstrual period to ensure immediate contraceptive protection, and if given later in the cycle, a backup contraceptive method should be used for 7 days.
The medication works by suppressing ovulation, thickening cervical mucus, and thinning the endometrial lining, as described in 1. Patients should be aware that return to fertility may be delayed after discontinuation, taking an average of 9-10 months for ovulation to resume. Common side effects include irregular bleeding, weight gain, and decreased bone mineral density with long-term use, as reported in 1. The injection must be administered by a healthcare provider and should not be missed to maintain effectiveness.
Key considerations for patients receiving Depo-Provera injections include:
- Counseling about age-appropriate recommendations for supplementation with calcium and vitamin D and regular weight-bearing exercise to maintain skeletal health, as recommended in 1
- Awareness of the potential for weight gain and the importance of monitoring weight status, as discussed in 1
- Understanding of the potential for delayed return to fertility after discontinuation, as noted in 1
- Importance of not missing injections to maintain contraceptive effectiveness, as emphasized in 1
Overall, Depo-Provera is a highly effective contraceptive method when used correctly, with a 1-year probability of pregnancy of approximately 6% for typical use, as reported in 1.
From the FDA Drug Label
The recommended dose is 150 mg of Medroxyprogesterone Acetate Injectable Suspension, USP every 3 months (13 weeks) administered by deep, IM injection in the gluteal or deltoid muscle The recommended dose of Depo Provera is 150 mg every 3 months (13 weeks) administered by deep, IM injection in the gluteal or deltoid muscle 2.
From the Research
Depo Provera Dose
- The recommended dose of Depo Provera is 150 mg administered every 3 months by deep, intramuscular injection in the gluteal or deltoid muscle 3.
- This dose has been shown to be effective in preventing pregnancy, with a failure rate of less than 1% in clinical studies 3.
- The same dose of 150 mg every 3 months has also been used in the treatment of endometriosis-associated pain, with significant improvements in pain scores and patient satisfaction 4, 5.
Administration and Side Effects
- Depo Provera should be administered only to women who are not pregnant, as fetal exposure may lead to low birth weight and other problems 3.
- Common side effects of Depo Provera include menstrual irregularities, weight gain, headache, nervousness, abdominal pain or discomfort, dizziness, and asthenia 3.
- Long-term use of Depo Provera may contribute to osteoporosis, and patients should be carefully counseled regarding this potential side effect 3.
Comparison with Other Treatments
- Depo Provera has been compared with other treatments for endometriosis-associated pain, including oral contraceptives and danazol 4, 5, 6.
- These studies have shown that Depo Provera is an effective and safe treatment option, with significant improvements in pain scores and patient satisfaction 4, 5.
- However, the choice of treatment should be individualized, taking into account the patient's medical history, preferences, and potential side effects 6.