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Depo-Provera Birth Control and Osteoporosis FAQ

What is Depo-Provera?

Depo Provera (generic name Medroxyprogesterone acetate) is a very effective contraceptive given by injection in the upper arm or in the buttocks four times a year –each shot protects you from becoming pregnant for 12 weeks. It is also known as DMPA, Depo shot and Depo Provera shot.

How does the Depo Provera injection work?

Depo-Provera injection contains progestin, a hormone similar to progesterone, which is a natural hormone produced in the body by the ovaries during the last two weeks of the menstrual cycle. Each Depo shot works by preventing the release of an egg from the ovary. If the egg is not released, you cannot become pregnant.

What are the advantages of taking Depo-provera over other birth control methods?

Pfizer, the manufacturer, markets the Depo shot as a “hassle and worry free” birth control method, saving women from daily pill popping—even though the risks outweigh the benefits. It is mainly popular with young women because of its higher pregnancy prevention rate and its convenience. According to Pfizer's website, Depo injection is effective in ending pregnancies more than 99 percent of the time.

Are there Depo-Provera side effects?

Depo-Provera contains a powerful variant of the hormone progestosterone, which has been linked to serious side effects, including long-term bone loss. According to a study in Obstetrics & Gynecology (January 2010) , 45 percent of women who received the Depo shot lost 5 percent or more of the bone density in their hips or lower spine. Researchers said the bone loss was of “significant concern” because recovering bone mass can take a long time, and the hip is the most common site for fractures in women later in life.

Another study published in the Archives of Pediatric and Adolescent Medicine documents bone loss or Osteoporosis in women while they were taking Depo-Provera.

Do those studies indicate inreased Depo Provera risk for some women vs. others?

Yes. Because the Depo Shot has been shown to increase the loss of bone density in women of all ages, teen and young adult women who are in critical stages of natural bone growth could be at greater risk. Some studies, however, claim that the bone loss may be reversible in younger women while other studies say the bone loss is permanent.

According to lead study author Dr. Abbey B. Berenson, women who smoke or do not get enough calcium in their diet are at greatest risk. Berenson advises patients who take the Depo shot to not smoke, and take your calcium every day. She also said that "If I have a patient who smokes, I'm going to be more concerned about giving her Depo-Provera."

More than two million American women use DMPA, including about 400,000 teenagers.

If I take Depo Provera, should I get a bone mineral density (BMD) test?

Health professionals recommend that you to take a done density test if you are taking Depo-Provera, and attorneys will likely advise a BMD to help determine whether you have a claim against the manufacturer.

A bone mineral density (BMD) test can identify osteoporosis, low bone density, and other osteo-related diseases. It can determine your risk for fractures (broken bones), and measure your response to osteoporosis treatment. The most widely recognized BMD test is called a dual-energy x-ray absorptiometry (DXA) test, a painless procedure similar to an x-ray. The test can measure bone density at your hip and spine.

Are there other Depo Provera side effects that should concern me?

Yes. If you are 35 years old or younger and began to receive Depo-Provera in the last four-five years, you may have a slightly increased risk that you will develop breast cancer. Depo-Provera may also increase the chance that you will develop a blood clot that moves to your lungs or brain.

Besides excessive weight gain, hair loss, headaches, muscle stiffness, and severe joint pain, Depo-provera side effects can also include:

• Menstrual irregularities such as bleeding and spotting
• Amenorrhea or not having any periods. ( After a year of Depo Provera injections, 57 percent of women are not menstruating; after two years of taking Depo shots, 68 percent of women are not menstruating.)
• Spotty darkening of the skin, usually around or on the face, which may be permanent
• Pregnancy-like symptoms include sore breasts, nausea, fatigue, and abdominal discomfort.

Has there been a Depo Provera FDA warning about any Depo shot risks?

In November 2004, the FDA announced that a black box warning would be added to the labeling of Depo-Provera Contraceptive Injection. The label warns Depo-Provera users that prolonged use may result in the loss of bone density, and that the loss may be greater the longer the drug is administered. (The FDA approved the drug in 2002.)

I have been taking Depo-Provera for the past year. Is there anything I can do to prevent bone density loss?

Besides not taking the Depo shot, you should eat plenty of foods that are rich in calcium and vitamin D in order to help decrease the loss of calcium in your bones. And don't smoke.

Are there ongoing Depo-Provera lawsuits?

Yes. Due to concerns that the drug causes massive and partially irreversible bone loss in young women, a number of Depo Provera lawsuits in the US and three lawsuits in Canada have been filed.

US Depo-Provera Lawsuits
According to The Record (Bergen County, May 11, 2009) New Jersey has a mass tort case involving Depo-Provera. ("Mass tort" claims involve a large number of lawsuits, often based on alleged injury from a single product; they are managed centrally because they involve similar factual and legal issues, and are therefore more cost-effective and timely.) In 2010 Pfizer settled several Depo-Provera class action suits in the US, and individual claims against the company are ongoing.

Canadian Depo-Provera Lawsuits
In September 2005, a Motion for authorization to institute a class action was filed with the Superior Court of Quebec on behalf of all persons resident in Canada having used Depo-Provera. In December 2005, a $700-million class-action lawsuit was filed against Pfizer in Toronto. The lawsuit claims that long-term users of Depo Provera have been diagnosed with serious bone density problems including but not limited to osteoporosis, fractures, brittle teeth, spine injuries, and hip injuries.

The Depo-Provera lawsuits also allege that Pfizer failed to forewarn doctors and patients of the serious bone density risks associated with long-term use of the drug and had originally promoted the injection as a safe contraceptive method for long-term use.

How can I join a Depo-provera lawsuit?

If you or a loved one has experienced any of the above side effects/symptoms while using Depo-Provera, you should first contact your doctor or other healthcare professional. Then you should seek legal help with an experienced attorney and determine whether you can be compensated for any injuries caused by Depo-Provera use.