My girlfriend just switched from Depo-provera to a BC pill called ortho-cept. She was on Depo-provera for about 2 years. When she first got on the shot everything seemed fine. As time went on she seemed to lose her sex drive. In addition to that she said sex was becoming painful. Well she went to the doctor and got tested for various infections and problems and came out clean. This process took quite a while. She had virtually no natural lubrication and we figured that was the cause of the pain. Well needless to say we have had sex maybe a handful of times in the last year or so. Before the shot we were having sex and everything was just fine.

Two weeks ago yesterday she began taking the ortho-cept birth control pill instead of getting her next shot. Since she started taking the pill she has noticed her breasts are tender, especially around the nipple area. She has also developed a discharge. We haven't tried sex yet since she switched to the pill.

Are these normal symptoms for starting or being on a birth control pill? Has anyone else noticed similar symptoms while being on Depo-provera or a birth control pill? We both feel like depo-provera was a mistake.

I haven't tried depo-provera or that particular type of pill, but I have heard lots of horrible stories about Depo-Provera causing all kinds of health problems that persist for some even after discontinuing the shot. But I can see how people would find it appealing.

The pill should have had an information leaflet in the packet listing all kinds of common side-effects, or you could look up the companies site and they should have a copy of it.

Breast tenderness is definately common.
The most common listed side effects for my pill include: headaches, nausea, vomiting, weight gain, breast tenderness, change in libido, depressive moods. It also says that vaginal discharge may occur as a result of an overgrowth in yeast, which is esily treated.
These should only last within 3 months while the body adjusts.

I guess all birth control would do the same as they are similar....

Originally posted by 13304:
My girlfriend just switched from Depo-provera to a BC pill called ortho-cept. She was on Depo-provera for about 2 years. When she first got on the shot everything seemed fine. As time went on she seemed to lose her sex drive.

This does seem to be a moderately common side-effect of the depo-MPA injection. Broadly summarised, women have two primary sex hormones. Oestrogen makes things grow, including breasts and the lining of the uterus (which is what makes the "periods") and very importantly, makes you feel good!, whilst progesterone cancels growth and favours certain secretory functions.

MPA (Provera/ Ralovera) is a progestogen - a synthetic progesterone, and giving it on its own causes a somewhat unbalanced situation in the progesterone direction - virtually no breast growth stimulation, trivial or no periods, and the woman misses out on the nice feeling Oestrogen gives her if her body "gives up" and doesn't make any by itself.

In addition to that she said sex was becoming painful. Well she went to the doctor and got tested for various infections and problems and came out clean.

Not surprising. One of the interesting side-effects of MPA is that it makes the vagina very unfriendly to Candida or "Thrush", and probably the other non-sexually-transmitted infections as well.

This process took quite a while. She had virtually no natural lubrication and we figured that was the cause of the pain.

That would have been exactly the reason. You have to (well, women have to...) enjoy sex to lubricate, and without lubrication, it hurts and of course, if it hurts, you don't enjoy it!

Well needless to say we have had sex maybe a handful of times in the last year or so. Before the shot we were having sex and everything was just fine.

What obviously varies from person to person, is how much the imbalance of hormones upsets things. Some have no problems at all (and even enjoy the freedom from "Thrush") while others just don't feel good.

Two weeks ago yesterday she began taking the ortho-cept birth control pill instead of getting her next shot. Since she started taking the pill she has noticed her breasts are tender, especially around the nipple area. She has also developed a discharge.

Both of these things indicate no more nor less than that her system has plenty of oestrogen in it and in fact, it had "forgotten" what the oestrogen feels like! You didn't mention the nausea.

We haven't tried sex yet since she switched to the pill. Are these normal symptoms for starting or being on a birth control pill?

Absolutely!

We both feel like depo-provera was a mistake.

Unfortunately, when things don't work out, which in this case means the treatment wasn't monitored properly, people start talking in ridiculously melodramatic terms such as "a terrible mistake" or "permanent damage" or "crippled me".

The injection must last for three months for contraception, and people want it to be reliable, so enough is given for four months, and it may keep working for six or slightly more months. But after that, the amount in the system becomes less than the natural hormone levels, and there are no residual effects from the hormone - it's just doing exactly the same job as if the body makes progesterone itself, but stronger.

A competent (in this area) doctor can combine the Depo-MPA, which is the most effective (actually, the implant is as good) contraception available, with the "pill" (actually, only Oestrogen is necessary, to re-balance things), to control bleeding for those who have irregular bleeding on Depo-MPA, and to improve mood and sexual desire. This means that you can use only enough Oestrogen (by patch or tablet) to get the good effects, but not cause heavy "periods", and have extremely effective contraception since the injection is still working, so there is no risk of pregnancy from missed pills, only possible bleeding.

It's actually a terrific form of contraception - if you understand it - and (the doctor does) know how to use it properly.

Paulb,I just had to comment when I read that you said that Depo Provera has no lasting effects. Have you not read the studies in which they found it has lasting effects on bone density? They have found that women on it for more than a year wind up losing quite a bit of their bone density. This has been proven and it is a lasting effect. Also there are cases of impaired fertility that can last YEARS or is even permanent. I was on Depo for six months. I stopped it because of the mood swings,loss of sex drive,weight gain,and the constant bleeding. I was warned of the the side effects except the bleeding and weight gain. I also knew that fertility should return between 3 to 18 months after the last shot. Well low and behold after those 18 months and no pregnancy I had to start seeing infertility specialists. I saw several over the following years in my search to get pregnant. We wanted a second child,just to let you know I had no problems before Depo. Anyway of those doctors everyone had had patients before me that were on Depo and having problems and they told me that I would not be the last they would have to treat thanks to Depo. I even had them tell me they wished Depo Provera had never been put on the market as birth control.
Depo Provera can have lasting effects that can go on for years and years. I know I fell into that area. If you do a search you can find several sites in which other women have had to deal with long term effects of Depo Provera and these effects are documented by doctors.
I know mine has been documented as have other friends of mine. I even know a few doctors who tell their patients not to use Depo Provera because of the long term effects they themselves have seen occur and what they have researched on it.

[This message has been edited by Blastoff9600 (edited 10-30-2002).]

She did mention she felt a little nauseated the first few days she started the pill. I think that has passed though. At least she has not mentioned anything about it. We both hope that the pill will get her back to feeling a little closer to normal.

OK, I'm going to give this a run. It may help somebody.

Originally posted by Blastoff9600:
Paulb,I just had to comment when I read that you said that Depo Provera has no lasting effects. Have you not read the studies in which they found it has lasting effects on bone density? They have found that women on it for more than a year wind up losing quite a bit of their bone density.

Actually, I haven't read the studies myself. And, let me tell you - this will intrigue you - that I haven't read the studies that demonstrate it has no effect on bone mass either. To be dreadfully truthful, I haven't the time that you have to read the studies, I have a lot more things to do.

However, lest you conclude that I'm "talking through my hat", let me now explain how I decide on what advice to give, both here and elsewhere. I make use of a fellow who was and is, required to read the studies - but not only the ones you can find on the Internet - no, all of them - in particular, the ones in the professional journals that are in general, not on the Internet, because you have to pay to subscribe to them.

And this highlights a problem on the Internet - you do have to be careful when you find some tantalising advice, to understand why the advice has been put on the Internet - who is paying for it to be there. Hopefully, it may be some government public health body providing the information for the public good, but there are many other "providers", with many and varied agenda. For example, when you search for "health" matters, you will find a lot of tracts published on "alternative health" or "healthy eating" sites, and lo and behold!, many of these are critical of "drug" treatments.

So perhaps you already realise this, but I thought I'd better mention it.

Anyway, I ran your concerns past my local gynaecologist (well, one of them), whom I trust for his advice, because I am in a position to see the consequences of his work and advice. In short, what I said before, and what I say to follow, is what he says, based on his expertise and training.

This has been proven and it is a lasting effect.

The summary is - no, nothing about loss of bone mineral density has been proven, and in particular, there is no substantial evidence of long-term effect. Studies have been varied on this point - some certainly have observed some loss of bone mass (and it shouldn't surprise you that these studies in particular, the "doom-sayers" have been preferentially reported in various media), whilst others have shown no such effect. "The jury is out" insofar as the evidence on balance doesn't tell you anything. Our current advice is that if you are on Depo-MPA, you should take plenty of calcium and get plenty of exercise - just as you should if you are on the "pill" - or indeed, just as you should if you are not on the pill (direct quote).

Oh, and one other thing - if anyone is so unmitigatedly stupid as to smoke and then come out and start discussing whether Depo-MPA, or the "pill", is bad for you, then they are more than welcome to ignore anything and everything I may say. There would be no point at all in my telling them anything.

Also there are cases of impaired fertility that can last YEARS or is even permanent.

Yes, and no. Your subsequent quote on the months is actually perfectly accurate, the exact numbers my fellow gave me, but "permanent" - there is no evidence whatsoever for any "permanent" effect on fertility.

I was on Depo for six months. I stopped it because of the mood swings,loss of sex drive,weight gain,and the constant bleeding. I was warned of the the side effects except the bleeding and weight gain.

Let's go through those in turn. Mood swings? Well, "Depo" is constant in the system, so it's not of itself going to produce mood swings. It may however as I stated before, reduce libido as it suppresses your androgens, or male hormones - I note on another topic here some mention of this effect, and if that causes your mood to "swing", then ... perhaps.

Weight gain? Yes, it does apparently enhance appetite and promote inactivity - much like pregnancy of course. Constant bleeding affects less than a quarter of users. The vast majority have no bleeding at all), and as I said previously, a good doctor can fix both this and the lack of oestrogen, in fact correct all the "problems" (including any possible loss of bone mass, but maybe not the excess appetite ;) ) if necessary, by combining it with an Oestrogen supplement.

And I'm really sorry that he did not mention bleeding or weight gain, as these are always the first I would mention - but only to point out that the first can be managed with supplementary oestrogen, and the second requires self-discipline.

I also knew that fertility should return between 3 to 18 months after the last shot.

It does - 18 months is the "world record". Six to nine months is normal.

Well low and behold after those 18 months and no pregnancy I had to start seeing infertility specialists. I saw several over the following years in my search to get pregnant. We wanted a second child,just to let you know I had no problems before Depo.

Yep, looks like you had a problem. The thing is, after the 18 months, it can't have been the "Depo", it was simply - you!

Sad fact of life - some women are, or become, infertile for various reasons. In total, about 10% of couples (which means between 5 and 10% of women, and between 5 and 10% of men - if that doesn't seem to add to 10%, then there are reasons ...). In a lot of these cases, it is "primary" infertility so that they have trouble having the first child, and if you have one, it should be pretty easy to have more, however, some people do have "secondary" infertility. Like the bumper sticker says, "**** happens!".

Anyway of those doctors everyone had had patients before me that were on Depo and having problems and they told me that I would not be the last they would have to treat thanks to Depo. I even had them tell me they wished Depo Provera had never been put on the market as birth control.

Hey, of course they had patients who had been on Depo - it's a popular form of contraception. They also had patients who had been on the pill, and they also had patients - and in fact, lots of them - who had never used either!

Perhaps you are too "close to the bone" to see the deep irony of an infertility specialist telling you he "wished Depo Provera had never been put on the market as birth control". Talk about sincerity! Well, yes, talk about it.

Depo Provera can have lasting effects that can go on for years and years. I know I fell into that area.

Sorry, no, you didn't. You had infertility, and you'd been on Depo-MPA, but there it rests. Sure, if you hadn't been on the "Depo", or on the "pill" (or using condoms), you might have got pregnant, but if you have a relative infertility, the later you wait, the less fertile you are. That is indisputable.

If you do a search you can find several sites in which other women have had to deal with long term effects of Depo Provera and these effects are documented by doctors.

I'm sure they are, but it's not worth anything. If they had "long term effects" of not having been on Depo-MPA, then it wouldn't have been worth talking about, would it? You may not understand the concept, but it's called "selective reporting", or in legal terms "circumstantial evidence", and it's just not admissible.

I know mine has been documented as have other friends of mine. I even know a few doctors who tell their patients not to use Depo Provera because of the long term effects they themselves have seen occur and what they have researched on it.

And I'm sure some doctors do. They are as it is said, "only human", and expecting them to understand the rules of evidence and scientific method, sometimes is just as tall an order for the doctors, as for their patients. In addition "reflecting" what a patient describes, as well as good old-fashioned gossip, are devices employed by doctors to indicate empathy and many say "if it works, it works!"

In summary, yes, there is a lot of gossip about Depo-MPA, just as there still is about the OCP ("the pill"). Please don't think I am discounting your problems, even if I seem to be - they are all quite genuine, and quite significant in your case, and in many other cases. People love however to dramatise their woes (it's therapeutic to an extent), generalising and scapegoating, and you have demonstrated that admirably.

It's true that the "depo" caused you various discomforts (but a better doctor could have relieved them), and it must be true that you had a problem with infertility. It just isn't true that you categorically would not have had the infertility problem had you used the "pill" or even condoms instead of the "depo".

Before Depo I did use other forms of birth control. The pill included. Like I said I had no problems becoming pregnant with my first son. Also the weigth gain wasnt due to increased eating or being lazy. I was actually walking and doing a regular exercise program at the time and I was barely eating at all. Hubby was extremely concerned at the time because I was lucky to feel like eating just once a day. And no there werent any snacking throughout the day.
I did suffer from mood swings because the first two weeks after my first and second shot I was a horrible person,hubby even considered divorce because I was so horrible.
I was actually quite young at that time also so age had nothing to do with my infertility. especially if you consider I am only 28 right now.
I have talked to other doctors over the years and some I wasnt even seeing for myself. I have known very few that would praise Depo. The studies I have read dont all come from online sources. Some I have read from various doctors thank you very much. The Bone Density study I actually read at one doctor's office.
Depo Provera can have long term lasting effects. I know that from the various studies and my own experience. I had to face alot when I found out I was had secondary infertility. The testing alone is not a fun thing to go through. Though for hubby it was a breeze for me it wasnt so grand. Of all the testing we both tested fine. One doctor was going to label it unexplained until she read the notes that I had been on Depo Provera. She then got to asking me various questions on that and added me to her list of names that she had in which others were effected by Depo.
I had to struggle for a while thinking I was at fault for my infertility. I at first never thought it would be because of birth control but from what I have read both online and offline. Then of course what variuos doctors have informed me of I dont blame myself.
It has been a while since I have had a chance to r ad any new studies but from what I have read I know Depo Provera should not be offered as birth control since so many doctors dont inform their patients of all the risks.

She was tested. Had to be examined by a doctor before switching bc methods.