Factsheet

The Contraceptive Injection - DMPA (Depo-Provera ®& Depo-Ralovera®)

Date   12 December 2007

WHAT IS DMPA?

DMPA, or Depot Medroxyprogesterone Acetate, is a chemical that is similar to the hormone called progesterone, which is produced in your body by your ovaries. In Australia it is sold as Depo-Provera® and Depo-Ralovera®. Each injection of DMPA protects you from pregnancy for 12 weeks.

HOW DOES IT WORK?

DMPA stops your ovaries from releasing an egg. If no egg is released, you cannot become pregnant.

HOW EFFECTIVE IS IT?

DMPA is a very effective contraceptive. If 1,000 women used it for a year, only one or two of them may become pregnant. It is more effective than the oral contraceptive pill. There are not as many accidental pregnancies with DMPA as there are with the contraceptive pill because you only need to remember to have the injection every 12 weeks, instead of taking a pill every day.

CAN ANYONE USE DMPA?

You will need to talk with your doctor or health provider before you start using DMPA. Tell them if:

• you could be pregnant
• you have any unusual or irregular bleeding or spotting from your vagina
• you have been treated for cancer of the breast or reproductive organs
• you have had severe depression
• you have heart or liver disease
• you are planning to become pregnant in the near future
• you have had an allergic reaction to DMPA in the past. Your doctor or health provider will talk with you about DMPA, and help you decide whether it is the best contraceptive method for you.

HOW DO I USE DMPA?

DMPA is given as a small injection into your buttock, or sometimes into the muscle of your upper arm. You are usually given the injection during the first five days of your menstrual cycle (the first day of bleeding with your period is day one). This is when you can be sure that you are not already pregnant. When you have the injection during the first five days, it prevents you from getting pregnant straight away. You can have DMPA later in your menstrual cycle if there is no chance that you could be pregnant (for example, if you have not had sex since your last period) but it will take another seven days before it is effective. You need to either avoid having vaginal sex, or use another contraceptive method such as condoms for those seven days, or you could get pregnant.

If you decide to use DMPA after having a baby, it is best to have your first injection five to six weeks after the birth. If it is given earlier than that, bleeding may be heavy or last longer. It is safe to use DMPA while you are breastfeeding, although you should be aware that small amounts of the hormone will pass to the baby in the breast milk. DMPA will not affect the quality or quantity of the breast milk.

It is important that you keep on having injections every 12 weeks to make sure you do not get pregnant. After the 12 weeks, you have two weeks to have your injection before there is an extra risk of pregnancy. DMPA does not protect you from sexually transmissible infections (STIs). You may decide to use condoms as well as DMPA, to help to protect you from STIs.

ARE THERE ANY SIDE EFFECTS?

DMPA always affects the menstrual cycle. Periods often become irregular and sometimes last longer, but heavy bleeding is not very common. You could have continual light bleeding for some weeks or find that your periods stop altogether. The longer you use DMPA, the more likely it is that your periods will stop, or you may just have an occasional light period. This is normal in a woman who is using DMPA, and is not an indication that you have any health problems.

Some studies have shown that there can be a loss of bone density (bone thinning) with extended use of DMPA. It is important to discuss this issue with your doctor and to establish whether you could be in a high-risk group for bone loss.

When you stop using DMPA your periods will take some time to return to their regular cycle. It usually takes about 10 months, although it may take up to 18 months. Some women may also gain weight, get headaches or feel depressed while they are using DMPA.

Talk to your doctor if you have any symptoms that you think might be caused by DMPA.

GETTING PREGNANT AFTER USING DMPA

Most women find that because it takes a while to return to a normal menstrual cycle after they have their last injection of DMPA, it can take even longer to become pregnant. DMPA is not a good contraceptive choice if you want to become pregnant in the near future - in the next 12 to 18 months. The number of DMPA injections you have had in the past does not seem to affect how long it takes for you to become pregnant. If you do not want to get pregnant when you stop using DMPA, you need to use another form of contraception.

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For further information

Contact the Healthline on 1300 658 886.