Q:  I am on Depo-Provera and know that it is 99% effective.  I also get very irregular periods, if I get them at all.  I am worried because I never can tell if I am pregnant.  Lately, I have been feeling kind of nauseous and moody.  I also have gained some weight.  Are there other signs I could look for if I am worried that I may be pregnant?

A:  Depo-Provera is a progestin-only contraceptive that is administered through injections.  The probability of becoming pregnant while on Depo-Provera is only 0.3% which makes it an extremely effective contraceptive option.  The symptoms you describe are characteristic of some of the side effects one might experience while using Depo-Provera.  Here are some of the advantages and disadvantages of using Depo-Provera:

Advantages:

  • Long-term effective contraception
  • Recommended for patients who are estrogen-sensitive
  • Absence of / or light menstrual bleeding
  • Decreased menstrual cramps and pain associated with endometriosis
  • Decreased risk of endometrial cancer, ovarian cancer, pelvic inflammatory disease (PID), and ectopic pregnancy
Disadvantages: 
  • Menstrual irregularity
  • Weight gain due to increased appetite
  • Depression or mood changes
  • No protection against sexually transmitted diseases (STDs)
  • Decrease in high-density lipoprotein (HDL) cholesterol levels
  • Possible decreased bone density after long-term use (smoking may be a risk factor)
  • Allergic reaction possible (although rare)
  • No immediate discontinuation (Depo-Provera is cleared from the body 6-8 months after the last injection)
If you are not pleased with your current method of contraception, visit the Campus Health, Women’s Health Clinic or your current health care provider to discuss other contraceptive options that might be more suitable for you.  Finally, if you are concerned that you might be pregnant, don’t wait around for signs -- get a pregnancy test.    

(Source: Contraceptive Technology, 17th Edition)