What is the definition of Provera Depo?
‘Medroxyprogesterone,’ a first-generation synthetic progestin, has been available in injectable form for decades. It is a prescription medication that offers contraception for 12 weeks with only one injection. Additionally, we have the Implanon Birth Control Implant, effective for three years.
Provera Depot is the most effective reversible contraceptive, having a lower failure rate than an intrauterine device or a combination tablet. However, its harsh and sometimes off-label injection techniques and widespread use as a mass contraceptive for women in low socioeconomic status settings have contributed to its poor reputation and an overemphasis on its dangers and side effects rather than its advantages. Additionally, it has several favorable impacts on Endometriosis and breast cancer treatment.
Besides, there is the Nexplanon Implant, which provides three years of contraception.
Upjohn Pharmacia first developed and commercialized it before being bought by Pfizer Pharmaceuticals International.
Depo-Provera Contraceptive Injection is manufactured by Pfizer (pfizer.com) (Manufactured in Belgium).
Clinical Dynamics – What is the mechanism of action of Depo Provera?
The progestin administration effects are prolonged when Depo Provera is administered in this depo suspension form.
Depo Provera is primarily used to inhibit ovulation. MPA (Medroxyprogesterone Acetate) inhibits the brain’s production of LH and FSH hormones in the blood. This prevents the ovary follicles from growing sequentially, resulting in no ovulation cycle after cycle.
Additionally, the endometrium, or uterine lining, becomes mushy or decidualized, rendering it incapable of absorbing a fertilized egg. Finally, the mucus at the cervix’s or womb’s mouth hardens and becomes impervious to sperms.
The anticancer properties of this compound are related to its inhibitory impact on the central-peripheral or hypothalamic-pituitary-tissue interaction axis. In other words, MPA inhibits the synthesis of natural or endogenous hormones, including estrogen, protecting cancer cells against estrogen-induced growth.
Obtaining And Displaying
Injectable birth control Depo Provera is often available in 1ml vials with a 150mg/ml concentration. Medroxyprogesterone acetate is the active component in Depo Provera. An aqueous solution of white powder is included in the vial. The box consists of a single-use syringe and a large-diameter needle.
Depo Provera Administration And Dosage
The injectable contraceptive Depo Provera is intended for deep intramuscular injection to ensure complete extraction of the solution from the vial with no residue.
Agitation or strong shaking of the vial before use is beneficial because it fully incorporates the drug into the solution, simplifying withdrawal and boosting availability. While injections into the buttock or deltoid are preferred, injections into the deltoid or arm are also acceptable. It is not intended for subcutaneous usage.
Injection of Depo Provera
Depo Provera (Medroxyprogesterone Acetate) is a long-acting oral contraceptive tablet to prevent pregnancy. Additionally, it is used to treat Endometriosis and breast cancer.
The first or first injection is administered during the first five days of menstruation.
It may be administered five days after delivery if the mother is not breastfeeding or six weeks postpartum (after pregnancy is ruled out) if the mother is exclusively breastfeeding.
Repeat the injection precisely 90 days later; it may be administered a few days sooner, but not later. It is not suggested to take this medication for more than one to two years due to the likelihood of long-term side effects.
It is administered in lesser dosages of 50 to 100mg weekly to twice a month for six months.
It is not utilized as a primary treatment for breast cancer but is combined with hormone therapy in postmenopausal women who are progesterone-receptive and have a recurrence. For the first 28 days, daily doses of 500 mg to 1 g are utilized, followed by a weekly maintenance dose of 500mg. However, treatment responses take time, and any unfavorable changes or advancement of the malignancy require that Depo Provera be discontinued immediately.
Endometrial/Renal System Cancer:
It is used as an adjuvant or palliative treatment in patients who cannot undergo surgery or have recurrence or metastasis of a certain kind of cancer. 500mg to 1gm is indicated initially, and the dosage may be decreased dependent on success.
Efficacy of Depo Provera – Contraceptive Advantages
The following table summarizes the efficacy and advantages of Depo Provera Contraceptive Shot:
- Depo Provera Shot is an easy-to-use treatment option since it requires one injection every 90 days.
- Culturally acceptable in areas where injections are favored over tablets.
- Attains almost total amenorrhea.
- Prolonged periods are avoided, which helps prevent iron deficiency anemia.
- Red blood cell pickling is decreased, making it an ideal contraceptive for women who have sickle cell anemia or other disorders.
- PA is good contraception for breastfeeding women, since it does not harm the amount or quality of breast milk or the newborn’s health.
- MPA is more effective and superior to contraceptive methods such as the IUD or the combination pill at preventing conception.
Reactions to the Depo Provera Shot
Several potential Depo Provera Shot side effects include the following:
Irregular Bleeding: Following the first injection of Depo Provera, it is usual to have unexpected irregular vaginal bleeding. These may vary from little patches to very bizarre excessive flow. Depo Provera injections administered continuously alleviate symptoms and eventually result in amenorrhea. Therefore, medical consultation and treatment with low-dose estrogens such as Ethinylestradiol or conjugated estrogens are necessary for women afflicted.
Loss of Bone Mineral Density (BMD): Estrogen is required for bone density maintenance. Depo Provera inhibits the hypothalamic-pituitary-ovarian hormonal axis, resulting in no estrogen production by the female body.
Low estrogen levels may result in osteoporosis or brittle bones due to loss of bone mass. After two years or more of usage, this effect is seen in premenopausal women. It is mostly reversible. Use by younger women may raise the chance of developing brittle bones later in life. Women with osteoporosis risk factors such as a low body mass index due to eating disorders, corticosteroid or anticonvulsant medication, a family history of the illness, or who drink or smoke are at an increased risk of bone loss.
It is widely established that stopping DMPA protects against endometrial cancer for up to eight years. In addition, numerous studies and clinical trials have shown that Depo Provera does not increase the risk of ovarian epithelial cancer, liver cancer, or cervicogenic squamous cell carcinoma.
There is no evidence of a statistically significant increase in the risk of breast cancer. However, there is some evidence of a modest increase in breast cancer risk for younger women under 35 who were exposed earlier. This danger is more significant for women under the age of 25 who have used it for more than two years.
Weight Gain: Weight gain is proportional to the length of usage. It was established that it fluctuated between 2, 4, and 6 Kg throughout 1, 2, and 4 years.
Diabetes: Depo Provera increases blood sugar levels by impairing glucose tolerance in some users.
Temporary Infertility: There is a delay in resuming fertility after the termination of Depo Provera. After cessation of usage, the median duration of pregnancy is eleven months.
Although no causal or direct link has been established, there have been reports of polysyndactyly (finger or toe webbing), chromosomal abnormalities, hypospadias in male fetuses, external genital virilization in female fetuses, and low birth weight babies born to women who become pregnant inadvertently while taking Depo Provera.
Additional adverse effects of the injectable contraceptive Depo Provera include the following:
- Symptoms such as constipation, diarrhea, and stomach discomfort are possible.
- Symptoms such as nausea, vomiting, liver failure, and jaundice are possible.
- Vaginal discharge is white, pelvic discomfort, vaginal infections, and cervical erosion.
- Adrenaline’s effects include increased sweating, minor tremors, and leg cramps.
- Hypertension, a penchant for blood clotting, heart attacks, strokes, and palpitations are all symptoms of hypertension.
- Platelet and white cell counts increased.
- Common skin problems include acne vulgaris, hirsutism, alopecia, and rashes.
- Pains and cramps in the bones, joints, muscles, and breast aches.
Contraindications to Depo Provera Contraceptive Injection
Contraception injection Depo Provera has the following contraindications:
- Unidentified or suspected pregnancy, as well as irregular menstrual cycles.
- Undiagnosed Hemorrhage in the vaginal canal;
- Breast cancer, whether suspected or diagnosed or breast cancer at a high risk
- Intolerance to medroxyprogesterone acetate or any other ingredients in the formulation.
- They are currently being treated for or have a history of blood clotting problems or predisposing factors such as thromboembolism, thrombophilia, brain or cerebral stroke, or severe uncontrolled hypertension.
- Contraindications include severe Hepato-Biliary illness or abnormal liver function tests.
Contraceptive Injection Precautions with Depo Provera
Precautions should be maintained while receiving a Depo Provera injection:
- Before initiating Depo Provera, visual anomalies must be re-examined medically, particularly those arising from the retinal vessels.
- Pregnancy, particularly ectopic pregnancy, must be considered in situations of vaginal bleeding, stomach discomfort, or a positive pregnancy test.
- Fluid retention is more likely to occur in users with a history of medical problems such as epilepsy, convulsions, asthma, migraine, or chronic cardiac or renal disease.
- While a Pap smear is preferable in women at increased risk of cervical cancer, one is beneficial before starting Depo Provera.
Interactions with Depo Provera, a birth control shot
Depo Provera has been demonstrated to compromise the laboratory analysis of the following tests.
Cortisol, estrogen, progesterone, and testosterone levels decrease in plasma or urine steroids.
Plasma or urine gonadotropins: Decreased LH and FSH levels.
The Metyrapone and Glucose Tolerance Tests provide variable results.
Increased coagulation test scores for components II, VII, VIII, IX, and X.
Panda.Healthcare offers the injectable contraceptive Depo-Provera. Depo Provera is available in 1 mL vials with a 150 mg/mL sterile aqueous solution. Additionally, we provide a needle with the disposable syringe when you get 15 injections of Depo Provera.
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