Depo Provera Made Me Sick

Years ago, (somewhere in the early 2000s) I decided to start using a hormonal birth control. After doing some research, I thought that Depo Provera would be a good choice.

It is administered by shot every three months, and is one of the most effective forms of birth control. Unfortunately for me, Depo Provera made me very sick – and the side effects are still here all these years later.

Warning: This blog post is going to contain a lot of what many may feel is “too much information”. It is probably not something everyone will feel comfortable reading. This post is also very long.

I wish I knew then what I know now about the side effects of Depo Provera, and how long they can linger. I’m writing this post in 2018, while suffering from the horrible symptoms that this awful drug inflicted upon me. Every time I lose weight – those symptoms return.

To be clear, I am aware that some women are able to use Depo Provera without experiencing any of the awful side effects that I have suffered through (and am still suffering from). I wasn’t one of the lucky ones.

My decision to seek out birth control was because I wanted to avoid getting pregnant. When I was younger, I miscarried – twice. The first time, I was probably about 19-years-old, and the second time I was in my mid-to-late 20s. Statistically, women in their 20s are the least likely to miscarry.  And yet, it happened to me twice.

Perhaps this shouldn’t have been a surprise, because I knew that my mom had a history of miscarriage. She never bothered to take or use any kind of birth control. Her mother, my Irish Catholic grandmother, literally would throw condoms at my mom and point out that using them prevents pregnancy.

The first time I got pregnant I honestly didn’t know I was pregnant. My periods had always been irregular. When I started throwing up, I thought I had the flu.

I miscarried in the bathroom of my boyfriend’s parent’s house (where we were staying) and woke up on the floor. His mother was there, and I was confused about what had happened. She blocked me from looking at the toilet, and no one ever would talk about it with me. The miscarriage was an unspoken – but known – thing that really strained the relationship I had with this boyfriend.

The second time I miscarried, I was alone in my apartment. I figured out I was pregnant after throwing up while on vacation. (Story for another time). I knew I was miscarrying. Once again, I passed out. This time I woke up alone. Both times I was fortunate enough not to require medical attention.

This time, the partner was my high school sweetheart whom I had gotten back together with after leaving the first boyfriend. (Again, story for another time). It was a long-distance relationship, which has its own difficulties.

For whatever reason, this miscarriage hit me a lot harder than the first one. I couldn’t find the words to talk about it – and this is likely what ended our relationship. Years later, I was able to tell him what happened. We haven’t spoken since then.

So, when my then-boyfriend, now-husband, and I got serious, I did the smart thing. I did some online research and learned everything I could about birth control. I needed something that would prevent pregnancy – and therefore, another miscarriage. He and I talked about it and neither one of us wanted to have children.

Some of the birth control options were just not for me. Birth control pills, for example, can be ineffective if you are also taking antibiotics. I got sick a lot, and was on antibiotics at least twice a year for sinus infections. The IUD contained copper, and I have metal allergies.

The Depo Provera shot seemed like the best option. It was administered by shot, didn’t require me to put a foreign object into my body that would have to be removed later, and did not require trips to the pharmacy to get more. The doctor I saw was at a clinic for poor people, where I was able to get a discount on the cost of Depo Provera.

This was long before Obamacare existed. I had no health insurance coverage. I did not qualify for Medicaid because I had no children. The clinic I went to was not a Planned Parenthood. I honestly believe that if it was – I would have gotten to see a good doctor instead of the one I got stuck with.

In short, this doctor tried to talk me out of using birth control. She pushed me to take “the pill” instead of the birth control I asked for. It seems the Depo Provera was expensive. I guess the clinic was more interested in cutting their costs instead of helping their patients.

This doctor seemed personally offended that I was avoiding having children. “I had four kids by the time I was your age,” she complained. I didn’t like this doctor, but there wasn’t any other option.

What I didn’t know at the time, and that my doctor should have been aware of, was that Depo Provera was problematic. An ABC News article, published in 2009, included the following:

…Produced by Pfizer, Depo Provera is the brand name for an aqueous suspension of medroxyprogesterone acetate, which is injected every 12 weeks in the woman’s buttock or upper arm to prevent ovulation. It is 97 percent effective in typical use.

The drug, which is also used to treat endometriosis, as well as other medical conditions, had a long safety record when it was first introduced in 1967.

The original manufacture, Upjohn, was repeatedly denied approval by the Food and Drug Administration in the 1970s, until 1992, when it was allowed to market Depo-Provera in the United States for contraception.

From this, I believe that Pfizer was aware that Depo Provera was causing bad side effects in some women. It must have known that Upjohn was having problems getting the FDA to approve the drug as a form of contraception.

I went ahead and tracked down the information about Depo Provera that was released by the FDA. One key point warns women about bone mineral density loss:

WARNING: LOSS OF BONE MINERAL DENSITY

Women who use Depo-Provera Contraceptive Injection may lose significant bone mineral density. Bone loss is greater with increasing duration of use and may not be completely irreversible.

It is unknown if use of Depo-Provera Contraceptive Injection during adolescence or early adulthood, a critical period of bone accretion, will reduce peak bone mass and increase the risk of osteoporotic fracture in later life.

Depo-Provera Contraceptive Injection should not be used as a long-term birth control method (i.e., longer than 2 years) unless other birth control methods are considered inadequate…

My doctor didn’t tell me about the risk of bone mineral density loss. She also didn’t appear to have any concerns about me being on Depo-Provera for more than 2 years. Here are a few more key parts of the FDA information (that my doctor never mentioned to me):

Bleeding Irregularities

Most women using Depo-Provera CI experience disruption of menstrual bleeding patterns. Altered menstrual bleeding patterns include amenorrhea, irregular or unpredictable bleeding or spotting, prolonged spotting or bleeding, and heavy bleeding. Rule out the possibility of organic pathology if abnormal bleeding persists or is severe, and institute the appropriate treatment.

As women continue using Depo-Provera CI, fewer experience irregular bleeding and more experience amenorrhea. In clinical studies of Depo-Provera CI, by month 12 amenorrhea was reported by 55% of women, and by month 24, amenorrhea was reported by 68% of women using Depo-Provera CI.

I was not among those fortunate enough to have the Depo-Provera stop their periods. My doctor never mentioned the information about irregular bleeding or spotting.

Weight Gain

Women tend to gain weight while on therapy with Depo-Provera CI. From an initial body weight of 136 lb, women who completed 1 year of therapy with Depo-Provera CI gained an average of 5.4 lb. Women who completed 2 years of therapy gained an average of 8.1 lb. Women who completed 4 years gained an average of 13.8 lb. Women who completed 6 years gained an average of 16.5 lbs. Two percent of women withdrew from a large-scale clinical trial because of excessive weight gain.

My doctor never mentioned that Depo-Provera can cause weight gain. She may have known about it, but failed to tell me. I cannot help but wonder why that was. Clearly, there were women in the study who gained so much weight from the Depo Provera that they decided they were better off without it.

In addition, the FDA information included tables of “adverse reactions” reported by the women in the study:

Table 1 Adverse Reactions that were Reported by More than 5% of Subjects:

• headache (16.5%)
• abdominal pain/discomfort (11.2%)
• Nervousness (10.8%)
• Dizziness (5.6%)
• Libido decreased (5.5%)
• Menstrual irregularities: bleeding (57.3% at 12 months, 31.1% at 24 months); amenorrhea (55% at 12 months, 68% at 24 months).

Now, lets compare that with the information the FDA allowed Pfizer to put on the Depo Provera packaging:

The most common side effects of Depo-Provera CI include:

• Irregular vaginal bleeding, such as lighter or heavier menstrual bleeding, or bleeding that does not stop
• Weight gain: You may experience weight gain while you are using Depo-Provera CI. About two-thirds of the women who used Depo-Provera CI in the clinical trials reported a weight gain of about 5 pounds during the first year of use. You may continue to gain weight after the first year. Women who used Depo-Provera CI for 2 years gained an average of 8 pounds over those 2 years.
• abdominal pain
• headache
• weakness
• tiredness
• nervousness
• dizziness

The warning on the box doesn’t mention anything about additional weight gain potential for the women who use Depo-Provera longer than two years. It also doesn’t show the percentage of women in the study who experienced weight gain, how much weight they gained, or the percentage of women who stopped taking Depo Provera because of excessive weight gain.

Instead, it presents an average weight gain (rounded down) for women who use Depo-Provera for one year. The assumption most women would take from this, lacking access to the rest of the FDA information, would be that they might gain 5 pounds. That’s simply not true for everyone who used Depo Provera!

The first side effect from Depo Provera arrived very quickly. I gained 30 pounds in a short span of time. Previous to taking Depo Provera, I was skinny, with a very fast metabolism. I’d never experienced this much weight gain, this fast, in my entire life.

At the time, I was working as a substitute teacher in the local school district. I started working at the Boys and Girls Club after school several days a week. There was very little time for me to eat anything, and I was always on my feet. It seemed to me that the weight gain was due to the Depo Provera. I searched online for information – but there wasn’t any.

One of the teacher’s aides that I worked with talked to me one day, when we were both alone and trying to use the copy machine. He asked when the baby was due. He thought I was pregnant. The weight I gained was exactly in the places where pregnant women get bigger.

It was embarrassing! I understand his mistake. Several of the teachers at that school were super pregnant. I looked just like they did. I explained to him that I was not pregnant; the birth control I was using made me look this way. He avoided visiting whatever classroom I had been assigned to after that.

The American Pregnancy Association states that, for women of average weight before pregnancy, with a BMI of 18.5-24.9, the recommended weight gain guideline is 25-35 pounds. The Depo Provera convinced my body that I was pregnant. Unfortunately, it also convinced co-workers and other people that I was pregnant. This was an undesirable side effect.

Eventually, when it was time to go back to get another Depo Provera shot, I tried to talk to my doctor about the weight gain. She told me that Depo Provera doesn’t cause weight gain, and that I just needed to get more exercise.

I’m not sure if the doctor knew that one of the side effects of Depo Provera is weight gain, because there wasn’t much data about that at the time. Even so, she should have taken my concerns seriously. It was as though she resented the women who came to her clinic and who were able to avoid having “four kids by the time I was your age.”

Depo Provera made me exhausted in a way that I’d never experienced before. For context, I have since been diagnosed with fibromyalgia, something I’ve had symptoms of since high school. The exhaustion from Depo Provera was worse. I would come home from work, lie down on the bed, and not really be able to move for a while.

I spent a summer or two working at a Boys and Girls club. I learned that going from air-conditioning to warm, muggy, Summer weather (or vice-versa) made me incredibly nauseous. Food smells would increase the nausea. It was worse than anything I’d experienced while actually pregnant.

As I mentioned, I’d never had regular periods. My hope was the Depo Provera would just turn it off for however long I was on the drug.  Instead, I spotted.  And spotted, and spotted. Periods would arrive on an even more random schedule than before. I had absolutely no idea when to expect a period to start, or end, and there could be more than one in a month.

When I was in high school, I was diagnosed as being borderline anemic. It gets worse when I menstruate. Constant spotting and random periods of indeterminate length were really bad for me.

The combination of all these side effects was that my sex drive disappeared. I sometimes use humor as a way of coping with bad situations. I joked that the reason Depo Provera prevents pregnancy is because the woman is either constantly bleeding or too exhausted and nauseous to even think about having sex.

If I had to guess, I might have stayed on Depo Provera for … three or four years? There was no other option, and my doctor insisted that the side effects I was experiencing simply weren’t real. Somewhere around 2004 or so, I switched to “the patch” – and to a different clinic, with nicer doctors.

No one asked me how long I had been on Depo Provera, and no one seemed to think it would be a problem to go directly from Depo Provera to “the patch”. I probably had some of both types of birth control in my system at the same time.

The nausea mostly went away, possibly as the Depo Provera wore off. I wasn’t as flat-out exhausted anymore. My periods remained irregular, but there was, eventually, less spotting. My sex drive sort of returned, but it was hit or miss.

I was probably on “the patch” for about two years. My husband and I decided to move out of state and across the country. When I was ready to use the very last “patch” I had access to – I wasn’t in a financial position to seek out more. So, I went off hormonal birth control for a while.

A study done in 2009 by the University of Texas Medical Branch at Galveston found the following:

Women using depot medroxyprogesterone acetate (DMPA), commonly known as the birth control shot, gained an average of 11 pounds and increased their body fat by 3.4 percent over three years, according to researchers at the University of Texas Medical Branch (UTMB).

However, women who switched to non hormonal contraception began to slowly lose the weight and fat mass they gained – nearly four pounds over two years, while those who used oral contraception after the shots gained an average of 4 additional pounds in the same time span. The amount of weight gain was dependent on the length of time DMPA was used, as the rate of weight gain slowed over time…

…According to [Abbey] Berenson, [M.D., professor in the Department of Obstetrics and Gynecology and the director of the Center for Interdiscplinary Research in Women’s Health at UTMB], the mechanism by which DMPA causes an increase in weight gain and fat mass is not known, and no connection was found between DMPA use and caloric intake, fat consumption or amount of exercise on body mass changes. The findings seem to argue against the theory that weight gain could be due to the drug’s perceived effects on increased caloric intake and decreased energy expenditure, but ongoing research is needed to confirm or discount varying possible explanations, she said…

The 30 pounds of extra weight stayed. I had switched from teaching to working in a bookstore, which required constant heavy lifting and tons of walking around. I should have started losing the Depo Provera weight – but that wasn’t happening. It made no sense to me at all.

In 2011, my sister asked me to be a bridesmaid at her wedding. For the first time in my life, I made an effort to lose some weight. Nobody needed my Irish aunties speculating about whether or not I was pregnant. I was definitely not pregnant!

I tried one of those low-carb diets. One of the things I learned from this was that I definitely should have been avoiding gluten all these years. I was diagnosed with an allergy to wheat, rye, and barley back in high school. This was long before allergists understood what to do about that, and long before doctors knew what celiac disease was.

One day, I ate a plate of whole wheat spaghetti noodles – and instantly started itching, having “brain fog”, and.. I’m gonna say “digestive issues”. I was able to talk about this with my wonderful acupuncturist, and have since avoided anything with wheat, rye, barley, or gluten.

Between the low carb diet, and the shunning of all that is gluten, I should have lost a decent amount of weight. My body cannot process gluten, so avoiding gluten should have reduced the inflammation it causes in my body.

Instead, I was only able to lose a little bit of weight before my sister’s wedding. I was enough to prevent the “is she pregnant” conversation from happening at the reception.

Since then, every time I started losing weight – all of the worst Depo Provera symptoms returned. There is no official data about Depo Provera being stored in your fat, but if you search around online, you can find women who reported that Depo is stored in your fat cells.

This is based on their own, personal, experience. I can only assume these women noticed, like I did, that the Depo Provera symptoms returned when their body burned some of the fat they got from Depo Provera. In a 2018 article about weight loss, CNN reported the following:

According to Dr. Caroline Apovian, president of the Obesity Society, frequently prescribed medications that can cause weight gain include Benadryl, Ambien, benzodiazepines, older antidepressant and antipsychotic medications, Paxil, beta-blockers (for high blood pressure), several diabetes medications including insulin, sulfonlyreas and thialidazones, and some contraceptive methods, including Depo-Provera.

Someone needs to do a study that can determine whether or not Depo Provera stores in fat cells. Perhaps that study will finally force medical care providers to recognize that women aren’t just making up symptoms and blaming it on Depo Provera. What we are experiencing is extremely real, and hellish, and a nightmare.

No one seems to care enough to do that. As such, women who use Depo Provera are unaware of the amount of weight gain the drug will cause them, AND have no idea the damned thing will store itself in the fat cells it created.

Everyday Health posted an FAQ about Depo Provera side effects. The information was medically reviewed by Dr. Sanjai Sinha, MD. Here is a small portion of that FAQ:

…Q: How long before Depo-Provera is out of your system? I am experiencing depression, stomach aches, and weight loss.

A: According to the prescribing information, it may take between 120 and 200 days following the injection for Depo-Provera (medroxyprogesterone) to be undetectable in the body. There was no mention, according to the prescribing information, of how long it would take for the side effects from Depo-Provera to go away after the medication was discontinued….

Sometime around 2012, I decided to get back on hormonal birth control. This time, after doing more research, I chose what was then called Implanon (and later called Nexplanon). It is a matchstick sized thing that is inserted under the skin in a woman’s upper arm.  You can literally touch it and make sure it is still in place and unbroken.

Implanon stays in your body for three years, and then must be taken out and replaced. By the time I needed to replace it, the drug had been renamed Nexplanon. I stayed on that for three years.

Overall, I was happiest with the Implanon/Nexplanon. It muted most of the horrible symptoms that I was still experiencing from the Depo Provera. It was a very effective form of birth control. I wish it existed back when I was first looking at birth control options.

When it was time to take it out, I decided not to replace it. By then, I was in my 40s. I knew that the older a woman gets, the higher risk she has of having her birth control cause a blood clot. My hope was that I’d be in menopause soon, and could get by without hormonal birth control until then.

What I didn’t realize was that I’d gained weight since the Depo Provera. That weight stayed around, sometimes dropping a few pounds, only to gain it back again. Every time I lost weight, the worst of the Depo Provera symptoms returned. It was as though the fat I burned released the Depo Provera it held right back into my blood stream.This has been going on for years.

In 2017, I started making an effort to lose weight. I’d heard that women who are older than 40, and who are obese, are at risk for a bunch of bad health problems. I hoped to avoid that. I can’t really do much exercise, because I have fibromyalgia, and severe allergies that force me to stay indoors when the pollen count is high.

Here are the changes I made beginning in March of 2017:

• Stayed off of hormonal birth control
• Greatly reduced the amount of sugar I consume
• Started eating more vegetables
• Became extremely picky about avoiding any foods that don’t say “gluten-free” on them
• Refusing to eat foods that had the slightest potential of being cross-contaminated with gluten
• Stopped eating foods that have “natural flavors” as an ingredient. I’ve had allergic reactions to some of them.
• Started walking around and playing Pokémon GO whenever my body, and the weather, will let me.

Slowly, very slowly, the weight started going away. I’ve been on this roller coaster of an existence in between feeling sort of ok to being super sick from Depo Provera again. At the time I’m writing this blog post, I have lost 40 pounds. There is still more fat that I should lose, and I’ll get there, slowly.

My hope is that someday, hopefully sooner rather than later,  Depo Provera will be cast out of my body forever.

My inspiration for writing this blog post is the horrible Depo Provera symptoms I’ve been experiencing this month. I went to a video game conference earlier this November, and ended up losing a few pounds. I’m at least a pound lighter since then.

My body is burning the fat that I originally gained from the first Depo Provera shot. I’m suffering. Its difficult to be constantly nauseous, experiencing abdominal pain and distress, and deeply exhausted for about a month straight. I wanted to write this for the women out there who are going through something similar.

You didn’t cause this. The Depo Provera did.  The symptoms you are experiencing are real and are happening to other women. You are not alone. I hope all of us can someday heal from the hell that Depo Provera has caused us.

Image from Pixabay

Depo Provera Made Me Sick is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites.