March 29, 2012

Questions Remain about Effects of Stopping Depo-Provera

Our 2009 post on side effects of stopping the injectable birth control Depo-Provera (depot medroxyprogesterone acetate, or DMPA) continues to generate important discussion — more than 100 women have shared their stories of adverse effects after stopping the drug.

Although a quick internet search finds many women complaining of or asking about post-Depo symptoms, there isn’t much published scientific evidence on the topic. Frustratingly, there is really not much new on the topic in the 2 1/2 years since we first posted on this. There don’t appear to be ongoing or upcoming studies on the concerns we’ve heard, either. A few studies here and there report some effects, like how long it took for menstruation to return, how long periods lasted, and how long it took to become pregnant after stopping.

Most of the existing research on women who stop using Depo-Provera seems to focus on bone mineral density. The drug comes with a “black box” warning that it may cause significant bone density losses, although research suggests that it’s possible that these losses may be made up after women stop taking the drug. The Society for Adolescent Medicine has said that “The data from all of these studies [of bone density in adolescent users] are encouraging, although it is unknown whether girls ultimately achieved the same peak bone mass as they would have in the absence of DMPA.” They also suggest that the advantages of preventing pregnancy may outweigh the risk for bone loss, but that patients should be informed of the potential for bone loss. Because of this concern, though, research on what happens when women stop using this birth control method tends to focus on understanding changes in their bone density.

Studies of “discontinuation” of birth control methods also tend to focus on the side effects of taking a drug and the reasons women stop using them, rather than what happens – aside from pregnancies – after they make that decision. It is thought that about half of women who quit Depo in order to get pregnant are able to do so by 10 months later, but that some women have longer waits before they are fertile. According to the drug label, “it is expected that 68% of women who do become pregnant may conceive within 12 months, 83% may conceive within 15 months, and 93% may conceive within 18 months from the last injection.” It also notes, though, that almost 40% of who discontinued the drug to become pregnant could not be followed up on, so they are not represented in those percentages.

What would you like to know about stopping Depo-Provera? What should researchers be examining? If you would like to share your own story of stopping Depo, please add them to the previous post.


13 Responses to “Questions Remain about Effects of Stopping Depo-Provera”

  1. Laura Wershler Says:

    Rachel, thanks for writing a follow-up post to your November 2009 post about the challenges women are facing coming off Depo-Provera. It was brought to my attention on re: Cycling, the blog of the Society for Menstrual Cycle Research in a post last weekend : http://menstruationresearch.org/2012/03/31/weekend-links-44/

    I write monthly for re: Cycling and am working on a series about coming off hormonal contraception and the many issues involved. Women’s comments at your original post inspired my most recent post:
    http://menstruationresearch.org/2012/04/04/coming-off-hormonal-contraception-is-depo-provera-different/#comments

    I support your call for more research into women’s experiences coming off not just Depo-Provera, but all hormonal contraceptives. We also need to do more to help women who stop using hormonal methods transition to healthy ovulatory cycles and effective, confident use of non-hormonal birth control methods.

    Laura Wershler
    @laurawershler

  2. callie Says:

    I have noticed Quite a few women have been experiencing the side effects of depo such as bone loss and brittle teeth. I have too its time we all get together and start a class action law suite and get this product off the market it is very dangerous and you don’t suffer the side effects until after you stop the drug. Please contact me if you too have these problems I have already contacted a lawyer about a class action. If you can be a part of it please do!! calliemorgan28@gmail.com

  3. Julia Says:

    I was on Depo in 1997-1999 and had no problems with it (I was 17 years old at the time of starting it). It did take almost a full year for my periods to return, and I was able to get pregnant in 2000…

    However, I went back on Depo in January 2013, not as a birth control but to help reduce (or eliminate) my periods because they were extremely heavy (and getting heavier by the month) and I was having horrible cramps. While the shot did eliminate the cramps and reduced the amount of blood I had during my periods, I have basically been on a continuous period since (it is now mid June). At first, they were 2 weeks long, with 2 weeks in between. However, in mid April I started and it was enough to wear regular tampons (the most I had since going back on the shot). That period lasted almost 5 weeks straight. I was barely off a week when I started again May 25th, and have been on it since (again today is June 18th). I was supposed to have had my 3rd injection yesterday but I am not going back on it. I am hoping that it is starting to leave my system as I have had some minor cramping the day before (I haven’t had cramps since being on the shot) and I seem to be getting heavier (not heavy, but more like a normal period). I don’t know what changed since I was 17, but I certainly didn’t get much relief going on the shot! I can see why it is such a good birth control method, because I can’t have sex (well I could, but not my cup of tea)…I don’t recommend this to anyone, all the websites I’ve read have said it can take 6-12 months for my body to go back to normal. It was never normal to begin with.

  4. Sammy Says:

    I started Depo in March 2009, and this last August (2013) I was to to get my shot again; but decided not to go in and get it.

    At the end of July of 2013 I had a very bad depressive episode; it was just a week before I was to get my shot in August. For a while now I have wondered if the depo shot has played with these episodes as every time I am about a week to get the shot something similar would happen- just this last one was bad- and am now finally taking that step to take care of me to see if it is.

    A Poster on the earlier article (Ashley) mentioned how she had similar symptoms as Bi-polar symptoms- I too would agree that was me.
    I even had a psychologist say that I was Bipolar2 in 2011- this while still on the shot. I had went in due to severe depression episodes, which stated in 2009 when my first shot was due. I remember the first time I was due for a shot, I just did not want to believe it was the Depo- no one else seemed to have these issues on Depo.. so it just was me right? I start to question that as I get older.

    Every 3rd month, when I was to get the shot I would have horrible mood swings and just be a mess; Which on the out side does appear to be “cycling” in a Bi-polar mood.

    However- Due to my family history with persons in my family dx’ed with Bipolar; every time I mentioned that I thought the Depo had some play in my depression and irritability and mood swings I was shrugged off and was told it was me- not Depo by doctors. Before depo- I did not cycle every 3 months, but on Depo I did- So I have to wonder how much the Depo does play with my mood swings.

    My last visit in May 2013 with my general doctor, she told me that the Depo “couldn’t” be the cause for any mood swings. And then she insisted that I get a women exam due to she was giving me hormone injections and that I could be putting her in a grey area for malpractice.
    She also wanted to put me on anti-depressants as well (which if I am bipolar would be a big no-no and she should know that being a doctor). I have refused her treatment as I don’t see her fit for the proper care in psychology; seeing she is a general doctor.

    I also totally disagree that “it couldn’t be the Depo” doing anything as I have been told over and over again when I bring it up; due to it is a hormonal injection, and hormones can play a lot with emotions and mood. but that is just my opinion.

    I find it odd that prior to receiving the Depo shot- I did not do this 3 month cycle of mood swings and how I would get while on the depo and needing to get the shot again.

    Right now it is September 2013, and it is not quite 3 months later but as of right now- I can honestly say that I do feel better off the shot right now. My Significant Other and I are paying attention, to see if on the 3rd or 4th month if I get like I did when it was shot time.
    I have also lost about 8 lbs- with just doing nothing but being me- But off the depo!

    Also if I could mention one more thing- which I do believe Depo played a part in, but I am not certain- But In 2010 I fell on the ice- I severely herniated 2 discs in my back. I had to have surgery due to they were so severe and that physical therapy would not help with getting the herniated disc back from pressing on my spine.

    That Whole Time with that ordeal- the Orthopedic Doctor and his team- Continuously said- At 24 years old; My Discs should not have done this, and there were no other issues that the could find that would contribute to what they did; “it was a mystery” why it happened.

    I will always wonder if the Depo Shot helped with making my discs more prone to being damaged; and now I have chunks missing out of two of them that may give me issues when I am older. No doubt the falling on the Ice was an impact- but at the same time I just have to wonder.
    I would had been a year or so into the Depo when this all happened.

    I just have to wonder some times… How much does this Depo shot play with these certain things; and I wish I did know more about the Depo. My First shots were in a Family Clinic that was for Low-Funded individuals. Absolutely nothing was told to me about the side effects; which is even more of an upsetting after I read some of them after I had been taking the shot for a while.

    Deep down in my gut- I think the Depo has contributed to a lot of things for me; and Now I will see if it did or not.. But thanks for letting me share my story here.

  5. Samantha Says:

    I have been on depo since may of 2013 and after my second shot in August I developed severe anxiety along with numerous other issues suh as hot flashes, depression, insomnia, no appetite, no sex drive, lost about 15lbs in 2 weeks from the constant nervous feing in my stomach. A whole host of GI issues, including upper abdominal pain after eating, diarrhea ( non stop for 3 weeks after injection) our bodies recognize as foreign andtries to get rid of it. More recent I have developed breast pain in my left breast that radiates to my shoulder an my neck. It’s just been miserable. I am hoping once the 3 months is up I will go back to normal.

  6. Cynthia Says:

    I feel the same exact way Samantha does. I felt that way on the shot and off it. I been off the depo ahot since May 3 2013. My last injection was Feb 2013. I did not go back in May to get it. It turned me into a complete different person. I’ve gotten the worst symptoms since being off: anxiety, I did get my period back which i got back at then end of july, nausea, headaches, dark brown discharge between my periods or before I’m fixing to start, insomnia when i do fall asleep I wake up so much throughout the night, bad pimple break outs before my period, constipation but when my period has started I use the bathroom pretty regularly, food craving or somedays i don’t even care to eat, sometimes I get backaches, my hair thinned on the side and in the back, and when I’m on my cycle I bleed pretty heavy. Mind you guys that I never had any of these symptoms until I got on the depo shot and stopped it.

    Since I’m off the depo now I feel my symptoms won’t ever stop. I just cope with them everyday. Somedays are better than others and how much I thank the lord for that. It’s been 5 months since being off that shot. I feel some improvement as far the night sweats and hot flashes stopping, but When will the other leave?

  7. Cynthia Says:

    I want to leave my email address for any ladies that need to talk or feel alone: mz_officer4053@yahoo.com

  8. Steph Says:

    I got the depo shot in July 2013, did not go back in Oct when I was supposed too. I just had my period 2 1/2 weeks ago and about a week ago I started getting horrible cramps and my boobs are really sore. I have diarrhea almost every day (I did have my gallbladder removed a month ago, so maybe that’s why?) But, my depression has gotten a lot worse since stopping Depo. I have been going through a lot at home, but regardless my dr added Abilify to my anti-depressent. I did get my period today which is early? Anyway, just wanted to know if anyone else has experienced any of these symptoms after stopping the shot? I was on the shot about 10 years ago, but didn’t experience any of these. Thank you!

  9. kayley Says:

    I started the depo January 2013 I have had endless problems since starting it, it started off with irregular bleeding , heavy bleeding , abnormal cramps so bad that I could not stand just curl up and cry, docs then prescribed me menfamnic acid which my body reacted to badly (docs insisted it was nothing to do with the shot yet I’ve never had a reaction to any medication) the irregular bleeding seemed to calm down after the second shot then I spotted 2 weeks before the shot which was bearable , I had a shot in July which I spotted straight after being jabbed (lasted a day) then in the August out of the blue I had immense pain and large clots l immediately went to see the doc and his only explanation was miscarriage I left the docs surgery a different woman, I was mortified as I was putting my body through this to stop pregnancy occurring . Anyway they suggested giving me the next shot early I had the shot and I’ve not been myself since, my last shot was due in December but both me and my partner agreed its not for me, since stopping the shot my back is in constant agony, I’m not keeping food down I’m constantly running to the toilet I’m a emotional wreck every joint hurts all I want to do is sleep this is effecting my home life a nd my work life it’s unbearable I used to be so happy! I’ve ordered angus castus tablets that people claim help get their body’s back to normal so here’s hoping it will bring back normality =)

  10. Cici Says:

    I have been on the depo shot for about a year and a few months. I was supposed to return mid December for another shot but I decided not to return. After the stop use of the shot I have been feeling depressed, bad mood swings, I don’t care to eat at all, bad cramps, light brown discharge, and food cravings. I feel horrible I’ve done a lot of reading online and it seems a majority of women have experienced these side effects. On top of everything my bones always ache. I wonder how long will I experience these horrendous symptoms??

  11. Terri Says:

    Dear Sammy, my case is exactly like yours and you are the first person on the internet I have found that gets so emotionally upset precisely three months after the depo provera shot. Everyone including my family thinks I have bi polar!!! I noticed about a year ago that I got more crabby exactly 3 to 4 weeks before injection time. Well, that crabbiness has turned into a life being wrecked, as too many people have been bitterly hurt by my harsh mean words. Also, I have a herniated disk, scoliosis and osteoarthritis. My back problems have been getting continually worse and worse to the point of not cleaning my house as I used to. I am age 45 and have been on depo about 17 years. Thank you so much for sharing. It is affirmative. I will not get the injection again. Ever. Tying the tubes or something….

  12. Susan Says:

    I started taking depo provera four year ago. It was not for birth control but to treat a condition called uterine fibroids or to control heavy bleeding. It worked like a charm and I thought it was great in the beginning!

    My weight crept up from 115 to 130pounds. I exercise on a regular basis and feel I’m pretty healthy but I could NOT lose the weight. I decided to stop taking the drug and I noticed a lack of appetite. I had to remind myself to eat. as a result I was not getting the required 1200 calories daily. It was waaaay under. as a result the weight feel off and I am now at 117 or less.
    It doesn’t feel healthy.

    Has anyone else experienced this problem? If you have please leave your contact email on this board.

    thank you

  13. Amy Says:

    I stopped the injection 4/5 yrs ago and still have not fallen pregnant, I’ve been trying from the moment I stopped it, I didn’t even know about any of the above that I just read until now. Iv been suffering from major depression & anxiety which started probably about a yr after trying n no luck. I already have two kids so it’s not like I can’t get pregnant.. Iv been suicidal from depression which started from my dreams of having another baby n starting a happier life with my partner ( not the father of my two children) after I was in an abusive relationship before him which took me years to brave enough to leave

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