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Provera: Risks
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Long-term studies of users of Depo-Provera have found slight or no increased overall risk of breast cancer. However, the study population did show a slightly increased risk of breast cancer in recent users (Depo use in the last four years) under age 35, similar to that seen with the use of combined oral contraceptive pills.[26]
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The results of the WHO study ... indicated that Depo-Provera use did not increase the overall risk of cancer of the liver or cervix. WHO reports that there is now substantial evidence that Depo-Provera protects against endometrial cancer, ovarian cancer, acute pelvic inflammatory disease, recurrent vaginal candidiasis, and endometriosis.
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Although they are rare, there are some serious health complications that can occur with the use of Depo-Provera. Users may have a slightly increased risk of breast cancer and cervical cancer, but study results have been conflicting. Other possible complications include jaundice, blood clots, severe allergic reaction and infertility.
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The U.S. Food and Drug Administration's advisory committee reported that Depo-Provera's "potential benefits outweighed the risks." Among the "potential benefits", according to Dr. David Kessler, U.S.F.D.A. Commissioner, "Depo-Provera eliminates problems relating to missing a daily dose."
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A slightly increased risk of breast cancer may exist for women under 35 years of age who use Depo Provera. According to the Food and Drug Administration, worldwide studies have found the overall breast cancer risk for long-term use to be minimal if it exists at all.
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It is unclear whether the bone density loss associated with Depo-Provera use is reversible, and if so, how completely. Three studies have suggested that bone loss is reversible after the discontinuation of Depo-Provera, although one notes that bone loss was not reversible in long-term users of Depo-Provera.[31][32][33] Other studies have suggested that the effect of Depo-Provera use on post-menopausal bone density is minimal,[34] perhaps because Depo users experience less bone loss at menopause.[35] However, as of 2006, no study has directly examined fracture risk in post-menopausal women who have used Depo-Provera; therefore, the risk is unknown. Pfizer and the FDA recommend that Depo-Provera not be used for longer than 2 years, unless there is no viable alternative method of contraception, due to concerns over bone loss.[28]
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