Contraceptive injections, also known as the “shots,” are probably the most discussable and controversial form of contraception. Though this birth control method was known to the scientists and doctors as one of the most effective and safe contraceptives since 1950s, it took more than 40 years for the first injectable contraceptive (Depo-Provera) to be approved by the U.S. Food and Drug Administration.
The story of this contraceptive approval is full of multiple aspects and unexpected turns; it includes not only pure medical issues, but many political, religious and social aspects, which all together caused the situation that Depo-Provera received the approval to be used as a contraceptive in the USA after women from 92 countries worldwide had already been using it successfully for many, many years. It is not possible to describe all the peripetia, associated with injectable contraceptives, within one article, but the most important and notable facts are given below.
The first application of Depo-Provera to the FDA for the use as a contraceptive came in 1967. Though the medication had already been approved at that time for the treatment of uterine and kidney cancers, the Administration failed to approve this new form of contraception. It is said that the reasons for their refusal were mostly political or social, but not scientific. Another effort to approve Depo-Provera was made in 1978, but it failed again. Finally, the medication was approved in 1992 after the World Health Organization proved safety and effectiveness of Depo-Provera in large-scale studies.
Another injectable contraceptive Lunelle became available in the USA in 2000, when it was approved by the U.S. Food and Drug Administration. However, nowadays Lunelle is no longer available because its marketing was discontinued.
The most up-to-date injectable contraceptive is called Depo-SubQ Provera 104, which is the low-dose version of Depo-Provera. It was approved in 2004.
The working agent of Depo-Provera is medroxyprogesterone acetate, a substance similar to female hormone progesterone. The medication is administered by injection into upper arm or buttocks once every 3 months.
Depo-Provera is a highly effective birth control method, which works by preventing ovulation or the release of eggs by ovaries. Besides, this contraceptive may reduce or even stop menstruation. The point is that with Depo-Provera the female uterus does not build lining or it builds only a very thin lining. Normally, such lining is released every month during menstruation, but if it is very thin, there will be very light menstruation or no at all.
The effectiveness of Depo-Provera is 99.7%. Besides, this rate of effectiveness is achieved only with 4 injections during 12 months.
The most common side effects, experienced by about 5% of patients treated with Depo-Provera, are menstrual irregularities, abdominal pain or discomfort, weight changes, dizziness, headache, asthenia and nervousness. Less common adverse reactions (experienced by 1-5% of patients) are decreased libido, pelvic pain, backache, breast pain, leg cramps, hair loss, depression, nausea, insomnia and acne.
Calcium loss or the decreased bone density is one of the most serious adverse reactions, associated with Depo-Provera use. Though the warning on this potential risk is emphasized in the patient information on Depo-Provera, it should be noted that the cases of calcium loss are very rare among the users of this injectable contraceptive.
Though all the theoretical, scientific and statistic information on Depo-Provera is extremely important, those women, who are looking for a proper contraceptive option, are interested in more practical data, such as advantages and disadvantages of a particular birth control method. So, here they are:
- High rate of effectiveness;
- no need to use contraceptive before each sexual act or to take pills daily;
- Depo-Provera causes fewer hormonal effects on female organism, such as blood clotting or thromboembolism, since it contains only one hormone (instead of two hormones in daily pills);
- lighter periods with the decreased bleeding during menstruation;
- Depo-Provera reduces the risks to develop cancer in the uterus or ovaries;
- high level of privacy and confidentiality (no one will see you taking pills or using patches, etc.);
- injectable contraception is a completely reversible type of birth control.
- Side effects (though their rates are quite low, injectable contraception does have certain adverse reactions);
- in order to receive the “shot” of injectable contraceptive, one should visit a doctor office;
- injectable contraceptives are not to be used for more than 2 years (because of potential decrease in bone density);
- injectable contraception does not protect from sexually transmitted diseases and HIV/AIDS.
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