NER: Depo Provera

Sharpschruter22

Hi ladies,

I have endometriosis and had been getting the depo shot for two years to stop my periods and hence stop the pain. I could only take so much of passing out in the shower so the shot was a Godsend.

I have not had a shot for a full year and my period has not returned. Now that I am to be married in 5 months, it is time for me to think about BC for the reasons it was created. I am 27 and FI and I want to wait 3 years to have kids. I'm nervous about starting the shot again because I'm scared of how long it will take me to become fertile again.

I know its not really true, but I feel like being on depo is more effective than pill forms. Not taking a pill every day is much easier and I like that I am not worried about forgetting and possibly becoming pregnant. There are 7 instances of aunts, cousins, and my mom getting pregnant while on bc. They claim they were taking it correctly and didn't have any medications that would have interacted. This terrifies me. We aren't ready for kids financially or mentally and need time as a couple first.

I don't know what to do. Should I continue getting the Depo shot for the next year and a half, then stop and take a pill or other form of BC while waiting for my fertility to come back around the time we would like to have a baby?

Avion22

These are really great questions for your doctor.   I don't have any personal experience with endo, but from other forums I post on, I know that it can be difficult to deal with while TTC (the pain, not necessarily coming off BC).

If you do not want to get pregnant, then the best form of BC is the one that works best for you.  If Depo works for your endo, then it's probably best to just stick with that.  However, you should tell your doctor about not resuming your period after a year with no Depo, and see what he/she says about what that might mean when you want to start TTC in a few years. From what I understand, doctors can give you drugs to jump-start your period if it doesn't come back after coming of BC.   This might be helpful for you.    You and your doctor can start to formulate a plan for when you do eventually decide to start trying -- including when to go off BC, how to get your body ready, and how to treat your endo when start trying.

I'm sorry if this wasn't very helpful.  Your doctor should be able to give you some better information.  And if they can't, or won't, then you should find a new doctor!!!

Sharpschruter22

Thanks, Avion! That's actually really helpful. It makes me feel better about going back on Depo. I didn't think of them giving me something to jump start my period again. I'm due for a gyno appt this month and wanted others opinions and experiences in order to ask more questions to my gyno.

AdeleDazeem

I agree with Avion - the best birth control is the one that works for you and you feel comfortable with.  Definitely discuss with your doctor the lack of period after coming off Depo and what they think about that.

Personally, I have never felt comfortable with progestin-only forms of birth control (which is what Provera is).  I never took the shot, but I took progestin-only pills for about a year.  Both GYNs I saw in that time period warned me that it wasn't quite as effective as dual pills (because the pills are only in your system for 24 hours so I had to be meticulous about taking them on time.)  Progestin-only also doesn't stop ovulation.  It all seemed very tenuous to me!  For these reasons, I'm most content on dual birth control.

You can always double up on forms, as well.  Some people do pills with condoms as an extra safety net.

Mom PSA: If you want to have sex, you're going to have to accept the possibility that whatever form you use may fail and you may end up pregnant.  It's not likely, but it's a possibility.

souptin

Hi,

from personal experience I would never recommend depo to anyone and here is why:

I was on it for 4 years without stopping (age 16-20) the shot depleted my bone density to the point I was osteopenic ( the early stages of osteoporosis) at 20 I was told I had the bones of a 55-60 year old woman. I asked if it could have been caused by anything aside from the shot-I was told on no uncertain terms that no, the depletion was due to the shot and many studies had been found to link the two.  At that time in Canada they were about to begin pulling it off the shelves. I am now 27 and my periods never went back to normal.
regular BC never worked well for me either and if you are looking for an alternative to taking a pill every day I have found having an IUD was (for me) the best route.
the insertion was uncomfortable but it is good for up to 5 years depending on what kind you get. I do not have experience with endometriosis but it may be something to consider talking to about with OBG.

Good luck!

hoffse

I ditto PP - my doctor switched me to the nuvaring because I get migraines on regular birth control.  He said it was because of hormone withdrawal (since the pill is in your body only so long which  means the hormones fluctuate all day long).  I love it - no migraines, I can't tell it's there, and I don't have to remember to take a pill at the same time each day.

Statistically, it's virtually impossible for you to know 9 people who got pregnant on the pill while taking it correctly.  The 99.9% effectiveness is with correct usage.  You have like a 1 in 100 million chance of knowing 9 people who didn't have user error and still got pregnant.  Not saying it's impossible, just virtually impossible.  A lot of women think they take it correctly but don't - my doctor told me it's literally supposed to be at the same moment of time each day for maximum effectiveness, and within the same hour each day for high effectiveness.  I doubt any of us do that.  Maybe there's some genetic thing going on in your family?  I've never heard of that, but it's the only way I see this being a realistic possibility.  All I'm saying is don't panic and assume you will get pregnant because you have family members who did.

Anyway, that's another reason he switched me to nuvaring - I'm an attorney and my mornings vary with work.  Even when I remember to take the pill, it's not necessarily at the same time each day or even within the same hour.  My fiance lives out of town for now so we don't have sex all that often at the moment, but I still wanted something more stable.  The ring gives off constant hormones so I don't have to remember to take anything, and the hormone levels are consistent and do not fluctuate.  PP is right: there is virtually no user error with it - I set an alarm on my calendar to remind me when to take it out and put a new one in, and other than that I don't think about it.  Most people don't feel it during sex at all, and it can come out for 3 hours at a time if you are one of the few who do.  It's also completely impossible to put it in wrong.  I worried about that at first, but I realized there's really no way to do it incorrectly, which is exactly what my doctor had told me.

The only thing I don't love about it is the price - on my insurance it's $88/month.

brideRegN

I would second the IUD, the Mirena specifically, especially long term. I have had mine for 4 years and will have it removed just before the wedding. It is widely prescribed for women that have endometriosis and/or in early menopause for heavy period but also for woman who wants longterm birth control. It is uncomfortable to be inserted but nothing worse than menustraual cramps which I am sure you are well accustomed to. It does provide coverage soon as it is inserted. Approximately 80% of woman do become period free within 8months.

In Canada, most OB/GYN don't like to prescribe it for the risk of early onset osteoporosis. My friend who is an OB/GYN doesn't prescribe IT ALL for that reasoning. 

But the best descussion is with your OB in a month. 

HTH

 

hoffse

I forgot to add - it also doesn't interact with antibiotics like the pill, because it is absorbed through the uterine wall instead of through the blood.  That was a nice perk - I rarely get sick but when I do I almost always need antibiotics to knock it out.

Also, my gyn said that plenty of women (including one of the female physicians who practices with him) don't have a period at all on it.  There are 35 days of hormones, so you can use one once a month for the entire month without having to buy 13 or 14 packs.

Sharpschruter22

Thank you all for your feedback. Of course everyone's body is different and such. I'm very happy with Depo, never had any problems, just concerned over the ability to bounce back when TTC. I've actually lost weight each year I have been on it, so the usual side effects have not affected me. For those of you recommending an IUD, have you all had children? I've previously discussed them with my gyno and she would not entertain the thought of it since I have never had a baby.

AdeleDazeem

Some doctors won't give IUDs to women who haven't had children.  There are more progressive doctors out there that will.  Look for one if you are interested.

Personally, I wouldn't get an IUD before having a child only because of the ever so small risk of it implanting in the uterine wall.  I don't want to damage my uterus before having children.  This is my hang up, however, not the doctor's.

EDIT: Yes, the reason doctors won't do it is because the insertion is more difficult or painful for a woman who hasn't had a child.  My reason for skipping the IUD is purely my own.

WinstonsGirl

In Response to <a href="http://forums.theknot.com/Sites/theknot/Pages/Main.aspx/wedding-boards_etiquette_ner-depo-provera?plckFindPostKey=Cat:Wedding%20BoardsForum:9Discussion:0770c8ed-9a64-47f3-9e51-bf2fd2445430Post:67ff026b-2306-42f5-84eb-997bb82eb640">Re:NER: Depo Provera</a>:
[QUOTE]Thank you all for your feedback. Of course everyone's body is different and such. I'm very happy with Depo, never had any problems, just concerned over the ability to bounce back when TTC. I've actually lost weight each year I have been on it, so the usual side effects have not affected me. <strong>For those of you recommending an IUD, have you all had children? I've previously discussed them with my gyno and she would not entertain the thought of it since I have never had a baby.</strong>
Posted by Sharpschruter22[/QUOTE]

<div>
</div><div>I've got a copper IUD and I've never had kids.  The only concern I've heard is that since I've never had kids, my cervix hasn't stretched/dialated to give birth, so it hurts more to have the IUD inserted.  I'm not sure if there are other medical concerns for women without kids.  And it did hurt like a mothertrucker, but I have no problems with it now.  I'm pretty happy with it.  Before, I was on BCP, which I did take at the exact same time every day.  I had an alarm set and so did DH, so I was bang on every day.  I was wanting something without hormones.  <div>
</div><div>Just so you know (and you may already), Mirena is a hormonal IUD, and usually your period stops.  Copper IUD's have no hormones, so you'll still get your period, which is usually a touch heavier and with slightly more cramping (mine got better as I had it longer), so I'm not sure how that may affect your endo.  If your Dr. won't do it though, find out why, and maybe consider a different Dr. if that's what will work best for you.  Good luck</div></div>

brideRegN

For me I had it inserted at my 6 week checkup post baby. Some OBs won't insert it if you haven't been pregnant before due to the fact it's harder to insert due to your cervix never being dilated , increasing chance of perforating the uterus with insertion. But in the same argument, c- section woman are in the same boat! 

In our clinic, we have loads of woman that haven't been pregnant with IUD. It can be done. Its the OB preference.

melb2013

OP, obviously I'm not a doctor, but I do have some thoughts.  I have extremely difficult PMS- I think they refer to it now as PMDD.  Having tried several pills, they actually made it worse and caused side effects.  I now use a natural supplement called Maca Root, which has done wonders.  I don't use any hormonal BC because of how bad I felt on it.  

If you really feel the only way to make yourself feel better is to be on the shot, go for it.  I doubt you'll get pregnant while on the depo shot, but like PP said, there is never a 100% and you have to be aware of that.

Once you go off of the shot and are waiting for your hormones to return to normal, there are non-hormonal options for BC.  I use a diaphram, which apparently is like a dinosaur these days, but it works.  It's what my mother and grandmother used and neither of them ever had a problem.  Because I'm super paranoid, we'll also use condoms sometimes in the middle of my cycle, but that's just my own mental thing.

And I'm with Joy on the IUD- that's always been my hang up with it.

MrsGandthebeag

Funny to read this thread today since I'm getting an IUD in about 3 hours.  I've never been pregnant and my doctor is willing to do it. I think it may also have to do with my age since I'm 32 and don't want kids.  Dh and I have been married for a year and a half.  

MoonlightSilver

In Response to <a href="http://forums.theknot.com/Sites/theknot/Pages/Main.aspx/wedding-boards_etiquette_ner-depo-provera?plckFindPostKey=Cat:Wedding%20BoardsForum:9Discussion:0770c8ed-9a64-47f3-9e51-bf2fd2445430Post:67ff026b-2306-42f5-84eb-997bb82eb640">Re:NER: Depo Provera</a>:
[QUOTE]Thank you all for your feedback. Of course everyone's body is different and such. I'm very happy with Depo, never had any problems, just concerned over the ability to bounce back when TTC. I've actually lost weight each year I have been on it, so the usual side effects have not affected me. <strong>For those of you recommending an IUD, have you all had children? </strong>I've previously discussed them with my gyno and she would not entertain the thought of it since I have never had a baby.
Posted by Sharpschruter22[/QUOTE]

<div>I had the Mirena IUD inserted when I was 20; no children. I got it while I was in Boston, so definitely a more progressive community, but you should be able to find resources on the internet for talking to your doctor about getting an IUD when you haven't had any kids. </div><div>
</div><div>IUDs are great because you don't have to remember to take a pill every day and they're extremely effective, but when you remove them you can get pregnant almost immediately (Paraguard right away, Mirena within a month it seems). There's a large upfront cost, but that's usually covered by insurance- after that, the only fee is to remove it (though you should be getting yearly checkups anyway). Having it put in hurt a bit, but you take some pain meds ahead of time and it just feels like bad cramps. Having it taken out, according to what I've read, is practically painless. </div><div>
</div><div>I love my IUD. </div>

pearlaqua

In Response to <a href="http://forums.theknot.com/Sites/theknot/Pages/Main.aspx/wedding-boards_etiquette_ner-depo-provera?plckFindPostKey=Cat:Wedding%20BoardsForum:9Discussion:0770c8ed-9a64-47f3-9e51-bf2fd2445430Post:67ff026b-2306-42f5-84eb-997bb82eb640">Re:NER: Depo Provera</a>:
[QUOTE]Thank you all for your feedback. Of course everyone's body is different and such. I'm very happy with Depo, never had any problems, just concerned over the ability to bounce back when TTC. I've actually lost weight each year I have been on it, so the usual side effects have not affected me. <strong> For those of you recommending an IUD, have you all had children? </strong>I've previously discussed them with my gyno and she would not entertain the thought of it since I have never had a baby.
Posted by Sharpschruter22[/QUOTE]

Get a new doctor, or really, insist on getting an IUD.  I have never had children and LOVE my Paragard (the copper IUD, no hormones!).

I don't know how endometriosis complicates the IUD for your, but I will say that I never had any sort of cramps on my period.  Once I got the IUD, wow! So many cramps! But they got better after a few periods on the IUD. 

AdeleDazeem

In Response to <a href="http://forums.theknot.com/Sites/theknot/Pages/Main.aspx/wedding-boards_etiquette_ner-depo-provera?plckFindPostKey=Cat:Wedding%20BoardsForum:9Discussion:0770c8ed-9a64-47f3-9e51-bf2fd2445430Post:68972a3c-6464-4b7f-a4d0-0e9bb08c9fb7">Re:NER: Depo Provera</a>:
[QUOTE]In Response to Re:NER: Depo Provera : That's pretty much EXACTLY why most doctors don't like giving them to patients with endometriosis or PMDD.   I love how whenever this comes up, everyone is all "talk to your doctor" until their doctor doesn't want to give them an IUD.  Then, it's "girl, find a new doctor who WILL."  Why do we suddenly decide we know more about the posters' medical condition and that they'll be fine on an IUD than their doctor does. ETA:  The second part isn't specifically aimed at pearl, more of a general WTF.  
Posted by StageManager14[/QUOTE]

I see what you're saying!  The only reason I said to find a doctor that would insert an IUD was because soooooome won't put it in a woman who hasn't had children.  If that's the only reason, yes, you can find a doctor who will do it.  However, if there are other reasons beyond that, then of course a competent doctor wouldn't even offer up the suggestion.

I honestly find birth control threads annoying because people  always throw around misinformation.  There's some in this thread that I'm trying to overlook.  Bottom line - talk to you doctor.  If you don't like her options, you are free to seek a second opinion.

mcda04

I currently have the Mirena IUD (5 years) because I am not good with pills, I'd probably forget to take them plus this is symptomless. I don't have a medical condition though so I wouldn't tell you to go get one without talking to your PCP first.

I'm actually in the process of having it removed though since I'm following my religion a little more but Kaiser's waiting list is ridiculous. I was very happy with it since I've had it for over 4 years and I've only had 2 periods in this timeframe.

Sharpschruter22

Lots of info here, thanks for the feedback. An IUD isn't in the cards for me for several reasons, but thanks for the info!

leia1979

In Response to <a href="http://forums.theknot.com/Sites/theknot/Pages/Main.aspx/wedding-boards_etiquette_ner-depo-provera?plckFindPostKey=Cat:Wedding%20BoardsForum:9Discussion:0770c8ed-9a64-47f3-9e51-bf2fd2445430Post:68972a3c-6464-4b7f-a4d0-0e9bb08c9fb7">Re:NER: Depo Provera</a>:
[QUOTE]In Response to Re:NER: Depo Provera : That's pretty much EXACTLY why most doctors don't like giving them to patients with endometriosis or PMDD.   I love how whenever this comes up, everyone is all "talk to your doctor" until their doctor doesn't want to give them an IUD.  Then, it's "girl, find a new doctor who WILL."  Why do we suddenly decide we know more about the posters' medical condition and that they'll be fine on an IUD than their doctor does. ETA:  The second part isn't specifically aimed at pearl, more of a general WTF.  
Posted by StageManager14[/QUOTE]

I understand your point, but doctors can have very different opinions with the same medical information. My doctor would not give me an IUD at age 27 because she didn't believe me that I didn't want children and was worried something might happen. Three years later it was no problem at all.

What changed? Not my medical history. The doctor herself got a Mirena and liked it. Then she was all in favor of me having one, too. I've never been pregnant, insertion really wasn't bad (thanks to medicine I was given before the procedure), and it's worked pretty well for me for almost 3 years so far. Though I understand OP said it wasn't a good choice for her.

gamecockwed

Some personal feedback:
I started on depo after I had my daughter in 1995. I was on it for 5 years. Never had ONE cycle while on it (my grandmother lectured me about this she said a body needs cleansing lol). When my husband (at the time) and I decided it was time for child number 2. The health dept(where I was getting the shots) said that I should have never been on the shot for 5 years (apparently they dont recommend that long consecutively). They told me it would take two years for my body to get back to normal. This was in May 2000. In September 2000, I had one day of spotting (and then nothing else at all). Didnt think anything about it. Come feb 2001 I was told I looked pregnant. I said nope dr told me two years. I decided to take a pregnancy test to prove her wrong. Lo and behold it came back positive. When we went to the dr, I found out I was 5 months pregnant! I was very lucky because I did things such as drink wine and change kitty litter because I had no clue I was pregnant(no signs, no movement no nothing). My son was born a healthy almost 9 pound baby July 6, 2001. So in just over a year-I got off the shot, had one day of spotting, got pregnant and had a baby.