Depo-Provera

Question 1

What are the mechanisms of action of Depo-Provera?

Answer 1

1. Inhibits ovulation

2. Thickens cervical mucus

Question 2

What is the regime for Depo-Provera?

Answer 2

1. IM injection every 3 months
2. Inject on day 1-5 of cycle (immediately effective)
3. If injected on other days, use condoms for 7 days

Question 3

What are the disadvantages of Depo-Provera?

Answer 3

1. Irregular bleeding in first weeks, usually followed by amenorrhoea
2. Delayed return to fertility - prolonged amenorrhoea can persist for up to 10 months after cessation
3. Bone density decreases during first 2 years then stabilises - not for use in adolescents or those with high osteoporosis risk
4. Weight gain
5. Efficacy reduced with hepatic enzyme-inducing drugs

Question 4

What should be done if someone is >5 days from new Depo-Provera and has unprotected sexual intercourse?

Answer 4

Emergency contraception