LYCOS RETRIEVER 
Provera: Depo Provera
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After stopping use of Depo-Provera CI (150 mg), there was partial recovery of BMD toward baseline values during the 2-year post-therapy period. Longer duration of treatment was associated with less complete recovery during this 2-year period following the last injection. Table 2 shows the extent of recovery of BMD for women who completed 5 years of treatment.
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Depo-Provera is a progestogen-only contraceptive injection that is given every 12 weeks. It is particularly suitable for those who cannot use oestrogen or who find it difficult to remember a daily pill. What is the effect of Depo-Provera on bones? Depo-Provera works by lowering levels of the female hormone oestrogen and these low oestrogen levels can reduce bone mineral density BMD ; , which is a slight thinning of the bones. Women who have used Depo-Provera tend to have lower BMD than women who have not used Depo-Provera. The effects of Depo-Provera on bone are greatest during the first 2-3 years of use.
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All women who use Depo Provera will have changes in their periods. A women may not know when she will have her period. Periods may be shorter or longer. Some women may have spotting continuously until the shot wears off. 50% of women who use Depo Provera for 1 year will no longer have periods. This is not a health problem.
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Women who take Depo-Provera may have irregular periods. They may include heavy bleeding, spotting, or no bleeding at all. After months of use, many women stop having periods. This change is usually not permanent. The periods should return after Depo-Provera use is stopped.
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Depo-Provera Suspension may cause a decrease in the amount of calcium in your bones. A decrease in bone calcium is of most concern if you have the following risk factors: adolescence, bone disease, anorexia nervosa (an eating disorder), a strong family history of osteoporosis, if you take certain medicines (eg, for epilepsy or steroids), or if you drink a lot of alcohol or smoke cigarettes often. If you need a birth control method for more than 2 years, your health care provider may switch you to another method or test you for weak bones. When Depo-Provera Suspension is stopped, the calcium in bones begins to come back. Your health care provider may recommend that you take calcium or vitamin D to help lower the amount of calcium lost from your bones.
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Depo-Provera works by lowering levels of oestrogen and other hormones. However, low oestrogen levels can cause bones to become thinner (by reducing bone mineral density). Women who use Depo-Provera tend to have lower bone mineral density than women of the same age who have never used it. The effects of Depo-Provera are greatest in the first 2-3 years of use. Following this, bone mineral density tends to stabilise and there appears to be some recovery when Depo-Provera is stopped. Research is being carried out to find out how completely the bones recover after long-term use of Depo-Provera. It is not yet known whether the effect of Depo-Provera on bone mineral density increases the risk of osteoporosis (weak bones) and fractures in later life.
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