Tuesday, January 26, 2010

No Babies: Shot 'o' Depo

We are nearing the end of our safari of hormonal manipulation, and I thought I'd bring in one of the more controversial before the finale. Depo-Provera, or Depo, was initially developed to treat uterine and cervical cancers, but was also found to very effectively prevent pregnancy in smaller doses. It is administered by injection, in a clinic, every three months.

Depo releases progestin, a female sex hormone, into the system. This prevents ovulation and thickens cervical mucus, making it nigh unto impossible for sperm and egg to meet and zygote it up. If injected on time every time, less than 1% of users will become pregnant while using it. That great percentage goes down quickly if shots are gotten late.

The main benefit is that it's birth control you think about only every 3 months, leading to increased efficacy and decreased pain-in-the-assedness. It's also very discreet, reduces the risk of uterine cancers, and can decrease menstrual flow significantly. The lack of estrogen makes it appropriate for women with cardiovascular problems, or who are breastfeeding. The shots are $35-$75 each, plus clinic costs.

Most of the side effects common to hormonal birth control also apply here - weight gain, mood disturbances, spotting between periods, headache, nausea, etc. The unfortunate thing is that if you do experience these, there's no way to reverse the shot - you've just got to deal for 3 months.

There are also some more serious side effects. The most talked about is that Depo causes temporary bone loss, which increases with prolonged use; as a result, the FDA placed a "black box warning" on packaging in 2004. Less commonly known is the 3-9 fold increase in risk for cervical cancer, and that some animals involved with the drug's testing developed breast tumors. Most shocking to me, however, is that babies exposed to Depo while still in the womb have an 80% chance of not surviving their first year. Ho-ly crap.

The controversy surrounding Depo is pretty significant. During many of the inital clinical trials, both in the US and the developing world, record keeping and protocol was shoddy, at best. It was unclear whether or not participants had been properly informed of the risks. In one major study, women with clear contraindications were given the shot anyway, and others were deliberately misinformed of the risks.

The vast majority of the participants were very poor women of color with limited education, groups that have been historically vulnerable to unethical scientific research practices, which raised questions about ethics and coercion. It's crap science like this that makes all clinical researchers look bad, and that is something this former clinical researcher takes kinda personally.

There's more detail about the controversy here, about 2/3 of the way down the page.

I have to say Depo is a method I have never considered using. I do have some friends who've used it and love it, but I've heard more horror stories than love stories. I'd love to hear your experience, if you've had one - I'm always down to learn something that might change my mind.

If you have any questions about any of this, give me a shout, or talk to your health care provider!

1 comment:

  1. I have both good and bad about depo.

    Bad news: It WAY shifted my moods and made me a bit crazy.

    Good news: not 2 weeks late of getting my shot I conceived my glorious son. But I guess for some, that also would be bad news since it is suppose to stop that whole baby making thing!

    Maybe it should just be good news that I managed to get laid while being such a psycho bitch while on it!

    Love your work, girl.....keep it up!