Microsoft word - is the shot right for me.docx

Is the shot right for me?
(Depo-Provera)
What is “the Shot”?
Depo-Provera is a progestin-only injectable form of birth control given by your health care provider every 3 months. It is injected into
either your upper arm or buttocks. The next shot should be scheduled in 12 weeks—this gives you a week or two of flexibility if you
are unable to keep that appointment.

How does the Shot work?
It prevents pregnancy by stopping ovulation (the release of an egg from the ovary). It thickens the mucus around the cervix. This
prevents sperm from entering the cervix and alters the lining of the womb to inhibit implantation of the pregnancy.

How effective is the Shot?
Depo-Provera is more than 99% effective. Of every 1,000 women who use this method, 3 will become pregnant during first year of
use. This is one of the most effective forms of birth control.

Am I a good candidate for the Shot?
Depo-Provera is worth considering if you want long-term contraception without following a daily routine. Since protection is
maintained from a shot every 3 months, it allows for sexual spontaneity. It may also be a good choice for you if you cannot remember
take a pill everyday or if you cannot use birth control containing estrogen (i.e. you are over 35 and a smoker or have a history of blood
clots.) It is also a good choice if you do NOT plan to become pregnant in the near future and want a reliable form of birth control
other than the pill. The shot does not protect from sexually transmitted diseases particularly HIV. If this is a concern you should use a
condom as well.

Are there any reasons why I shouldn’t use the Shot?
Most women of any age needing birth control can use Depo-Provera. A woman should not use the shot if she has history of:
active liver disease current or past history of breast cancer unexplained vaginal bleeding
What are the common side effects of the Shot?
•IRREGULAR BLEEDING. Almost all women who use Depo-Provera will experience changes in their period, including irregular or
unpredictable bleeding or spotting, and occasionally heavy or continuous bleeding. This tends to subside the longer you use this
method. After a year of use, one-half of women will stop having a period altogether. This is an expected side effect from the shot and
is NOT a medical problem. The constant release of hormone in your body from the injection prevents the lining of the uterus from
building up; therefore, there is nothing to bleed off each month. If the irregular bleeding is interfering with your lifestyle, talk to your
health care provider. This can be treated by either taking a short course of estrogen (i.e. taking the birth control pill) or medications
such as Motrin or Advil to regulate your cycle for a few months until the irregular bleeding resolves.
•WEIGHT GAIN. Depo-Provera has been shown to be associated with weight gain. As much as 3 to 5 lbs. in the first year of use. This
is most likely due to increased appetite from the progestin. If you watch what you eat and exercise regularly you can offset this
weight gain.
•DELAY IN THE RETURN OF YOUR PERIOD. Although the shot does NOT cause infertility, it may take 12 to18 months from your last
injection for your normal menstrual function to return (the average is 10 months). Thus, if you are considering pregnancy in the near
future you may want to consider an alternative method of birth control.

•NO IMMEDIATE DISCONTINUATION. Unlike, the pill or minipill, the hormone given as an injection can take several months to clear
from your body. Thus, you may be “stuck” with some of the other side effects such as irregular bleeding, weight gain, etc. for several months. •REVERSIBLE LOSS OF BONE MASS. Women who use Depo-Provera for a long period of time may have lower density than non-users.
This will reverse after stopping the Depo-Provera and has not been shown to cause osteoporosis or associated fractures. Women over 40 who continue this method for greater than 2 years would benefit from having their bone density checked. Julianne M. Dunne, MD, PC * 1230 Mamaroneck Ave Suite 100 White Plains, NY 10605 ( (914) 948-1020 •MOOD CHANGES. Some women experience mood changes on the shot—depression, irritability, and change in sex drive. These are
infrequent side effects.
What are the benefits of the Shot?

•easy to use--all you have to remember is to go to your health care provider for a shot 4 times a year •extremely reliable—this form of birth control has one of the lowest failure rates •confidential--no one other than your health care provider needs to know you are using it •decreases menstrual cramps and blood loss--after 1 year of use 50% of women will no longer get their period •reversible--although expect a delay in the return of your period of 10 months on average •protective effect in reducing the risk of endometrial cancer
When can I start taking the Shot?
We will only give you the Depo-Provera within 5 days of the start of your menstrual period. This ensures that you are NOT pregnant
when you receive the shot and it will be effective immediately. Before you get each shot we will check that you have a negative urine
pregnancy test.
Another time to start this method is after the end of a pregnancy; either at the time of termination of pregnancy or within 5 days
postpartum if NOT breastfeeding. If you plan to breastfeed, Depo-Provera is a safe method of birth control but we recommend
waiting until 6 weeks postpartum when the milk supply is fully established. If you initiate Depo-Provera after the birth of a child,
keep in mind the delay in return of your menstrual cycle once you stop the method if you are planning to have another baby within the
next year or so. In that case, you may want to select a different form of birth control.
What If I am late for my next Shot?
If you are late for your Depo-Provera, we want to make sure that you are NOT pregnant. However, now we need to do a blood
pregnancy test to make sure you are not pregnant. This is much more sensitive than a urine test. The blood test usually takes one day
for results. If negative, you could return the next day for your injection but you should use condoms as a backup method for the next
two weeks.
Are there any warning signs I should look out for once I start the Shot?
Call your doctor if you have any of the following problems:
•repeated, very painful headaches •heavy bleeding (soaking more than one menstrual pad per hour) •depression •severe lower abdominal pain •pus, prolonged pain, or bleeding at injection site Julianne M. Dunne, MD, PC * 1230 Mamaroneck Ave Suite 100 White Plains, NY 10605 ( (914) 948-1020

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