Depot Medroxyprogesterone Acetate (DMPA) Injection

Introduction

Depot medroxyprogesterone acetate (DMPA), also known as the depo shot, is a type of contraceptive injection that contains the hormone progestin. It is used to prevent pregnancy and is administered via intramuscular injection every 12 weeks (or 3 months).

How it Works

DMPA works by preventing ovulation, which means that eggs are not released from the ovaries. It also thickens cervical mucus, making it difficult for sperm to reach an egg if one is released. Additionally, DMPA causes changes in the uterine lining, making it less likely for a fertilized egg to implant.

Administration

The DMPA injection is typically administered by a healthcare provider in the upper arm or buttock. The first injection can be given at any time during the menstrual cycle, as long as pregnancy can be ruled out. Subsequent injections are usually given every 12 weeks, with a 4-week grace period allowed for each injection.

Benefits

The benefits of DMPA include:

• Highly effective in preventing pregnancy (over 99% effective)
• Convenient and easy to use, with injections given every 3 months
• Reduces menstrual cramps and bleeding
• Lowers the risk of endometrial cancer
• May reduce the risk of ovarian cysts and pelvic inflammatory disease (PID)

Risks and Side Effects

Common side effects of DMPA include:

• Weight gain
• Irregular menstrual bleeding or spotting
• Headaches
• Dizziness
• Nausea and vomiting
• Breast tenderness
• Mood changes (such as depression or anxiety)

Contraindications

DMPA is not recommended for women who:

• Are pregnant or think they may be pregnant
• Have a history of breast cancer
• Have liver disease or liver tumors
• Have a history of blood clots or stroke
• Are taking certain medications, such as anticonvulsants or barbiturates

Return to Fertility

After stopping DMPA injections, it may take several months for fertility to return. On average, it can take around 9-12 months for ovulation to resume and for women to become pregnant after stopping the injections.

Monitoring and Follow-up

Women using DMPA should have regular check-ups with their healthcare provider every 3-6 months to monitor their health and address any concerns or side effects. Blood pressure and weight should be monitored regularly, and a physical exam should be performed annually.