Depo Shot Cramps: Understanding Medroxyprogesterone Contraception Side Effects

13.07.202121.07.2023 by alexxlab

What are the precautions for using Depo Provera. How does this contraceptive injection work. What are the potential side effects of medroxyprogesterone. Who should and should not use Depo shots for birth control.

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What is Depo Provera and How Does It Work?

Depo Provera is a hormonal contraceptive injection containing medroxyprogesterone acetate, a synthetic form of progesterone. This long-acting reversible contraceptive is administered via intramuscular or subcutaneous injection every 12 weeks, providing continuous pregnancy prevention.

The contraceptive mechanism of Depo Provera involves:

Suppressing ovulation by inhibiting the release of eggs from the ovaries
Thickening cervical mucus to prevent sperm from entering the uterus
Thinning the uterine lining to make implantation less likely

By maintaining consistent hormone levels, Depo Provera effectively “switches off” a woman’s natural hormone production and menstrual cycle. This action is similar to oral contraceptive pills but delivered in a long-acting injectable form.

Effectiveness and Reliability of Depo Shots

Depo Provera is highly effective when administered correctly every 12 weeks. Its contraceptive efficacy is approximately 99.8%, making it one of the most reliable birth control methods available. However, it’s important to note that no contraceptive is 100% foolproof.

Factors influencing Depo Provera’s effectiveness include:

Consistent and timely administration of injections
Proper injection technique by healthcare providers
Individual metabolic variations

Despite its high efficacy, about 6 in 100 women may still become pregnant while using Depo Provera. This failure rate is considerably lower than many other contraceptive methods, making it a reliable choice for those seeking long-term birth control.

Common Side Effects and Body Changes

While Depo Provera is an effective contraceptive, it can cause various side effects due to its hormonal nature. Understanding these potential effects is crucial for women considering this method.

Menstrual Changes

One of the most notable effects of Depo Provera is its impact on menstrual bleeding patterns. Users may experience:

Irregular spotting or bleeding, especially in the first few months
Lighter periods or complete cessation of menstruation (amenorrhea)
Occasionally, heavy or prolonged bleeding

These changes occur because Depo Provera maintains low, stable hormone levels, preventing the uterine lining from thickening as it normally would during a menstrual cycle. Consequently, there’s little to no lining to shed, resulting in reduced or absent menstrual flow for many users.

Weight Fluctuations

Weight changes are another commonly reported side effect of Depo Provera. While not universal, some users may experience:

Modest weight gain, typically 1-2 pounds per year
No significant weight change
In some cases, weight loss

The relationship between Depo Provera and weight gain is complex and may be influenced by factors such as diet, exercise, and individual metabolism.

Mood and Libido Changes

Hormonal fluctuations associated with Depo Provera can sometimes affect mood and sexual desire. Some users report:

Mood swings or increased irritability
Decreased libido or interest in sexual activity
Depressive symptoms, particularly in those with a history of depression

These effects are not universal and may vary significantly among individuals. Women with a history of mood disorders should discuss this with their healthcare provider before starting Depo Provera.

Advantages of Using Depo Provera

Despite potential side effects, Depo Provera offers several advantages that make it an attractive contraceptive option for many women:

High effectiveness: With proper use, Depo Provera is 99.8% effective in preventing pregnancy.
Convenience: The need for only one injection every 12 weeks eliminates daily medication routines.
Discreet: As an injection, it’s a private contraceptive method that doesn’t require visible contraceptive use.
Reduced menstrual symptoms: Many users experience lighter periods or amenorrhea, which can alleviate menstrual cramps and PMS symptoms.
Potential health benefits: Depo Provera may reduce the risk of endometrial cancer, ovarian cancer, and pelvic inflammatory disease.
Non-estrogen based: Suitable for women who can’t use estrogen-containing contraceptives.
Breastfeeding compatible: Can be used by nursing mothers without affecting milk production.

These benefits make Depo Provera a valuable option for women seeking long-term, hassle-free contraception.

Potential Risks and Long-term Considerations

While Depo Provera is generally safe, there are some potential risks and long-term considerations that users should be aware of:

Bone Density Concerns

Long-term use of Depo Provera has been associated with a slight decrease in bone mineral density. This occurs because the low estrogen state induced by the injection can affect bone metabolism. Key points to consider:

The bone density loss is generally small and reversible after discontinuation
The risk is more significant in adolescents whose bones are still developing
Women using Depo Provera long-term should ensure adequate calcium and vitamin D intake
Regular exercise, particularly weight-bearing activities, can help maintain bone health

Healthcare providers may recommend bone density scans for long-term users, especially those with other risk factors for osteoporosis.

Delayed Return to Fertility

After discontinuing Depo Provera, it may take some time for fertility to return. Important points include:

On average, it takes 9-10 months after the last injection for ovulation to resume
Some women may experience a delay of up to 18 months
Over 80% of women who wish to conceive do so within 15 months of their last injection

This delayed return to fertility is a crucial consideration for women planning future pregnancies.

Cardiovascular Considerations

While Depo Provera doesn’t contain estrogen, which is associated with increased cardiovascular risks, some studies suggest a potential link between progestin-only contraceptives and slight increases in cardiovascular risk. However, this risk is generally considered low in healthy women.

Who Should and Should Not Use Depo Provera?

Depo Provera is suitable for many women seeking reliable, long-acting contraception. However, it’s not appropriate for everyone. Understanding who can safely use this method is crucial for making informed contraceptive choices.

Ideal Candidates for Depo Provera

Depo Provera may be an excellent choice for:

Women seeking highly effective, long-acting contraception
Those who prefer not to take daily pills or use barrier methods
Women who can’t use estrogen-containing contraceptives
Breastfeeding mothers (can be started 6 weeks postpartum)
Women with heavy or painful periods, as Depo Provera often reduces menstrual symptoms
Those with certain medical conditions that contraindicate estrogen use, such as migraine with aura or high risk of blood clots

Women Who Should Avoid Depo Provera

Depo Provera is not recommended for women with:

Current or suspected pregnancy
Unexplained vaginal bleeding
Breast cancer or a history of breast cancer
Severe liver disease
High risk of osteoporosis
Plans to become pregnant within the next year
History of stroke or heart disease
Uncontrolled high blood pressure

Women with a history of depression should consult their healthcare provider, as Depo Provera may exacerbate depressive symptoms in some individuals.

Managing Side Effects and Optimizing Depo Provera Use

While side effects can occur with Depo Provera use, many can be managed effectively. Here are some strategies to optimize the experience:

Dealing with Irregular Bleeding

Irregular bleeding is common, especially in the first few months. To manage this:

Keep a menstrual diary to track bleeding patterns
Use panty liners or light pads for spotting
Consult your healthcare provider if bleeding is heavy or prolonged
Consider short-term use of NSAIDs or additional hormonal treatments if recommended by your doctor

Minimizing Weight Gain

To help prevent or manage weight gain:

Maintain a balanced, nutritious diet
Engage in regular physical activity
Monitor weight changes and discuss concerns with your healthcare provider

Bone Health Maintenance

To support bone health while using Depo Provera:

Ensure adequate calcium intake (1000-1200 mg daily for most adults)
Get sufficient vitamin D through diet, supplements, or sunlight exposure
Incorporate weight-bearing exercises into your routine
Consider bone density scans if using Depo Provera long-term

Mood Management

If experiencing mood changes:

Practice stress-reduction techniques like meditation or yoga
Maintain a regular sleep schedule
Engage in regular exercise, which can boost mood
Seek professional help if mood changes are significant or persistent

Remember, not all users experience side effects, and many find that the benefits of Depo Provera outweigh the potential drawbacks. Open communication with your healthcare provider is key to addressing any concerns and ensuring the best possible experience with this contraceptive method.

Alternatives to Depo Provera: Comparing Contraceptive Options

While Depo Provera is an effective contraceptive choice for many, it’s important to consider all available options. Here’s a comparison of Depo Provera with other common contraceptive methods:

Long-Acting Reversible Contraceptives (LARCs)

Other LARC options include:

Intrauterine Devices (IUDs):
- Hormonal IUDs (e.g., Mirena, Kyleena): Last 3-7 years, may reduce menstrual bleeding
- Copper IUDs: Non-hormonal, last up to 10 years
Contraceptive Implant (e.g., Nexplanon): Lasts up to 3 years, inserted under the skin of the upper arm

Compared to Depo Provera, these methods offer longer-lasting protection and may have fewer systemic side effects.

Short-Acting Hormonal Methods

These include:

Combined Oral Contraceptive Pills: Taken daily, contain estrogen and progestin
Progestin-Only Pills: Taken daily, suitable for those who can’t use estrogen
Contraceptive Patch: Applied weekly
Vaginal Ring: Inserted monthly

These methods require more frequent user action compared to Depo Provera but offer quicker return to fertility upon discontinuation.

Barrier Methods

Non-hormonal options include:

Condoms (male and female)
Diaphragm or Cervical Cap with spermicide

These methods have lower effectiveness rates than Depo Provera but don’t involve hormones and can be used on-demand.

Natural Family Planning

This involves tracking fertility signs to avoid pregnancy. While hormone-free, it requires significant user commitment and has lower effectiveness rates than hormonal methods.

When choosing between Depo Provera and other contraceptive options, consider factors such as effectiveness, convenience, side effects, and personal health history. Consulting with a healthcare provider can help determine the most suitable method for individual needs and preferences.

Depo Provera | The Royal Women’s Hospital

Depo Provera is a hormone used for contraception. It is given by injection and its effects will last for three months at a time.

It is similar to progesterone, which is one of the two main hormones made by a woman’s ovaries during her normal cycle.

How does Depo Provera work?

When a woman has Depo Provera, her body senses the presence of the hormone so that her own hormone production is ‘switched off’. Because of this, her ovaries will not release an egg and this is how pregnancy is prevented. This is very similar to how the Pill works. Depo Provera is also sometimes used in the treatment of endometriosis.

How well does it work?

Depo Provera is a highly effective method of contraception when it is given every three months (99.8 per cent effective). About one in twenty (six per cent) of women will still get pregnant when using Depo Provera; this is very low compared with other methods.

Side effects

During a normal menstrual cycle, your hormones cause the lining of your uterus to thicken in preparation for a pregnancy. If you don’t get pregnant, the lining of your uterus breaks away and you bleed – this is your period.

When you have Depo Provera, your hormone levels are low and stable throughout your cycle, so the lining of your uterus doesn’t thicken as it normally would. When it comes time for your period there is very little lining to shed and so you bleed less than you normally would.

After two to three injections, many women will have no periods at all because there is no lining building at all. Some women will have nuisance bleeding, which is usually light and irregular. Occasionally a woman will have troublesome heavy bleeding, which can usually be controlled by hormone treatment.

Other effects

A small amount of weight gain sometimes occurs, although many women have no change and some lose weight.
Some women may be troubled by headaches, abdominal discomfort and mood changes.
Some women have a reduced interest in sex, particularly women who are prone to depression.
A small minority of women experience other side effects, which may be a nuisance but are unlikely to be serious. These include allergic reactions, fluid retention and breast soreness.

Advantages

Depo Provera is highly effective with a very low failure rate.
For many women the loss of periods is an advantage with relief of symptoms such as premenstrual tension and period pain.
Depo Provera is also likely to cause some reduction in risk of ovarian cancer, endometrial (uterine) cancer, endometriosis and possibly pelvic infection.
An injection is given every 12 weeks and no other effort or remembering is required.

Disadvantages

Some women do not wish to see their doctor every three months for an injection.
Some women experience side effects as already described, which may be uncomfortable or unpleasant.
Once the injection has been given, the hormone cannot be removed. If a woman wants to stop the Depo Provera she has to wait for it to wear off. In some women, periods can be slow to return after the injections are stopped – sometimes 6 to 12 months. However, more than half will fall pregnant within 12 months and over 90 percent within two years.

Other things to think about

Hormone levels are very low while using Depo Provera, so there is some concern that this may lead to thinning of the bones (osteoporosis) in women who use Depo Provera for a long period of time. The importance of this is not yet known, but the changes would be expected to happen more slowly than those that occur normally after menopause and reverse after the injections stop.

Although it is extremely difficult to prove a complete lack of risk, Depo Provera has not been shown to have any effect on the risk of breast cancer. It should be noted that protective effects against cancer of the ovary and uterine lining are very likely. No ill effects on the developing baby have been shown to occur if Depo Provera is given when a woman is already pregnant or in the very rare case where a woman becomes pregnant despite the injection.

Who can use Depo Provera?

Depo Provera can be used by most women who do not have any serious medical problems and by many women who use other forms of contraception. It may also be suitable for women who cannot take the combined pill for medical reasons.

Who should not use Depo Provera?

Depo Provera is not suitable for women who are experiencing the following:

bleeding disorders or taking anticoagulant medication
undiagnosed abnormal bleeding
history of some forms of cancer
certain other serious medical problems
already pregnant
wanting to become pregnant within 12 months.

Where to get more information

Your local doctor (GP)
Women’s Welcome Centre (Victoria only)
Tel: (03) 8345 3037 or 1800 442 007 (rural callers)

Information about long acting reversible contraception (LARC), including contraceptive injections, is also available in Arabic, Chinese, Hindi, Spanish, Urdu and Vietnamese – see Related Health Topics below

Depo-Provera – Uses, Side Effects, Interactions

How does this medication work? What will it do for me?

Medroxyprogesterone acetate belongs to the class of medication known as progestogens. It is used to prevent pregnancy. It works by preventing a woman’s egg from completely developing. It also thickens the mucus around the cervix, making it harder for sperm to reach the egg. Medroxyprogesterone acetate is also used to treat endometriosis.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

150 mg/mL
Each mL contains 150 mg of medroxyprogesterone acetate. Nonmedicinal ingredients: hydrochloric acid, methylparaben, polyethylene glycol, polysorbate, propylparaben, sodium chloride, sodium hydroxide, and water for injection.

How should I use this medication?

For birth control, the recommended intramuscular (IM) dose is 150 mg injected into a muscle by a health care professional every 3 months. Intervals between injections must not be more than 13 weeks. If an injection is not received within 13 weeks, a pregnancy test should be done before any further treatment with medroxyprogesterone.

This medication is usually started within the first 5 days after the onset of a normal menstrual period. If the injection is given within the first 5 days after the onset of a normal menstrual period, it is effective from the day of injection. However, if it is given later during the menstrual cycle, it may not be effective for the first 3 to 4 weeks after the injection. A non-hormonal “back-up” method of birth control, such as latex condoms with spermicidal foam or jelly, should be used during this time.

After having a baby, the first injection of medroxyprogesterone should be given within 5 days of giving birth, if the mother does not plan to breast feed the baby. If the mother is going to breast feed, the first dose should not be injected until at least 6 weeks after the birth of the baby.

When used to treat endometriosis, the usual dose is 50 mg injected into a muscle once a week, or 100 mg injected into a muscle every second week for at least 6 months.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is very important that this medication be used exactly as prescribed by the doctor. This preparation is not to be used intravenously (injected into a vein). If you miss an appointment to receive medroxyprogesterone acetate injection, contact your doctor as soon as possible to reschedule your appointment.

Store this medication at room temperature, protect it from freezing and light, and keep it out of the reach of children. It should be shaken well just before using.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not use medroxyprogesterone if you:

are allergic to medroxyprogesterone or any ingredients of the medication
are or may be pregnant
have a history of clotting disorders, or blood clots
have risk factors for developing blood clots (e.g., severe high blood pressure, genetic changes that cause blood clots, severe cholesterol problems, are a heavy smoker and over age 35, have blood vessel problems because of diabetes)
have a history of heart attack or heart disease
have a history of migraines with auras
have a history of stroke
have liver disease
have or may have a cancer that is dependent on progestin
have undiagnosed vaginal or urinary tract bleeding
have undiagnosed or confirmed breast problems (e. g., cancer)
have vision problems caused by vascular disease

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

abdominal pain or cramping
acne
back or joint pain
bloating
breast swelling or tenderness
changes in menstrual bleeding:

increased amounts of menstrual bleeding occurring at regular monthly periods
heavier uterine bleeding between regular monthly periods
lighter uterine bleeding between menstrual periods
stopping of menstrual periods

decreased bone mineral density
dizziness
fatigue
hot flashes
increased appetite
leg cramps
loss or gain of body, facial, or scalp hair
loss of sexual desire
lump, indentation, scar, or change in colour at the injection site
mild headache
nausea
nervousness
pain or irritation at place of injection
pain in the pelvic area
skin reaction or irritation at the site of injection
trouble sleeping
unusual tiredness or weakness
vomiting

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

breast lumps
headache or migraine that gets worse
signs of depression (such as feeling sad, losing interest in things you used to enjoy, weight changes, changes in sleep habits, feelings of guilt or worthlessness, thoughts of suicide)
signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
swelling of the arms or legs
symptoms of a urinary tract infection (e.g. pain when urinating, urinating more often than usual, low back or flank pain)
unexpected vaginal bleeding

Stop taking the medication and seek immediate medical attention if any of the following occur:

broken bones
difficulty moving a part of your body (paralysis)
seizures
signs of a serious allergic reaction (e. g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
signs of blood clots (e.g., coughing up of blood; pains in chest, groin, or leg, especially in calf of leg; swelling or redness in the legs; sudden loss of vision or developing double vision)
signs of heart attack (e.g., sudden chest pain; pain radiating to back, down arm, jaw; sensation of fullness of the chest; nausea; vomiting; sweating; anxiety)
signs of stroke (e.g., confusion; sudden or severe headache; sudden loss of coordination; sudden change in vision; sudden slurring of speech; unexplained weakness, numbness, or pain in arm or leg)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.

Blood clots: This medication has been associated with blood clots developing in the bloodstream. These blood clots may form anywhere in the body but are more noticeable when they occur in the large muscles, lung, brain (stroke), or heart (heart attack). If you experience pain in the chest or leg, unexplained shortness of breath, blurred vision or slurred speech, contact your doctor immediately.

Certain conditions such as long-term bed confinement may make blood clots more likely. Discuss with your doctor the risks and benefits of temporarily stopping this medication if you are scheduled for surgery, and let all doctors involved in your care know that you are taking this medication.

Bone loss: Medroxyprogesterone causes bone loss, and adolescent women whose bones are still forming and have not yet reached their peak bone mass should discuss any concerns with their doctor. It is not known if this will influence peak bone mass and increase the risk of osteoporosis in the future. If you are considering using this medication, discuss the risks and benefits with your doctor.

The amount of bone loss depends on how long a woman uses this medication. This bone loss may not be completely reversible. You should discuss these risks with your doctor. The risk of bone effects may be greatest in early adulthood and adolescence.

Cancer: For some women, there may be a slightly increased risk of breast cancer associated with the use of medroxyprogesterone acetate injection. Long-term studies showed no increased risk of ovarian, liver, or cervical cancer, and a reduced risk of endometrial cancer. Talk to your doctor if you have any concerns about this medication.

Cigarette smoking: There is an increased risk of negative side effects on the heart and blood vessels for women who smoke and are using medroxyprogesterone acetate. If you smoke, discuss the benefits of stopping smoking with your doctor or pharmacist. There are tools that are available to make this easier.

Depression: Hormones, such as medroxyprogesterone acetate have been known to cause mood swings and symptoms of depression. If you have depression or a history of depression, discuss with your doctor how this medication may affect your medical condition and whether any special monitoring is needed.

If you experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, or decreased interest in activities, or notice them in a family member who is taking this medication, contact your doctor as soon as possible.

Diabetes: Some women receiving medroxyprogesterone experience decreased blood glucose control. For this reason, women with diabetes should carefully monitor their blood glucose while receiving medroxyprogesterone acetate. Discuss with your doctor the ideal frequency with which you should check your blood glucose.

Fertility: Research indicates there is no evidence that medroxyprogesterone causes infertility. It may take some time for the injection to wear off, and most women must wait about 6 to 8 months after the last injection to start ovulating, having regular periods, and be able to become pregnant.

Fluid retention: Since progestogens may cause some degree of fluid retention, conditions such as epilepsy, migraine, asthma, or reduced heart or kidney function might be influenced by this medication. If you have any of these conditions, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

High blood pressure: The fluid retention mentioned above can contribute to increased blood pressure. If you are treating high blood pressure or may be at risk of developing high blood pressure, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Irregular menstrual patterns: Menstrual patterns commonly change following the use of medroxyprogesterone. This includes irregular or unpredictable bleeding or spotting or, rarely, heavy or continuous bleeding. If undiagnosed vaginal bleeding occurs, or if abnormal bleeding persists or is severe, consult your doctor.

As women continue to use medroxyprogesterone, fewer experience irregular bleeding patterns and more do not menstruate at all. By Month 12, about 55% of women no longer have periods, and by Month 24, about 68% of women using medroxyprogesterone do not have periods. Because of the prolonged effect of the medication, re-establishment of menstruation may be delayed and difficult to predict.

Liver disease: If you have liver disease or are at risk of developing liver disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. The doctor will probably monitor liver function with regular blood tests. If you develop signs of liver disease (such as yellowing of the skin or eyes; or swelling, pain, or tenderness in the upper abdominal area), contact your doctor as soon as possible.

Migraine and headache: Medroxyprogesterone acetate may make migraine symptoms worse. The onset or worsening of a migraine or the development of new types of recurrent, persistent, or severe headaches should be reported to your doctor. If you already experience migraine or severe headaches, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Sexually transmitted infections: This medication does not protect against sexually transmitted infections, including HIV/AIDS. For protection against these, use latex condoms.

Weight changes: Weight gain may be associated with the use of medroxyprogesterone. The majority of studies report an average weight gain of 2.5 kg at the end of one year, but only 2% of women stopped treatment due to excessive weight gain.

Pregnancy: This medication should not be used by pregnant women. To help ensure a woman is not pregnant at the time of the first injection, it is recommended that the first injection be given only within the first 5 days of the onset of a normal menstrual period, or only within the first 5 days after childbirth if the mother is not breast-feeding.

Breast-feeding: This medication passes into breast milk. If you are breast-feeding and are taking medroxyprogesterone, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children. Medroxyprogesterone is not intended to be used for young women before menstruation begins (menarche). It should only be used for adolescents between 12 and 18 years of age when there is no other suitable medication or form of birth control.

What other drugs could interact with this medication?

There may be an interaction between medroxyprogesterone acetate injection and any of the following:

aprepitant
“azole” antifungals (e.g., itraconazole, ketoconazole, voriconazole)
barbiturates (e.g., phenobarbital, butalbital)
bosentan
cannabis
cladribine
cobicistat
deferasirox
dexamethasone
diabetes medications (e.g., acarbose, canagliflozin, glyburide, insulin, linagliptin, lixisenatide, metformin, rosiglitazone)
echinacea
elagolix
flibanserin
HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., efavirenz, etravirine, nevirapine)
HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
idelalasib
lumacaftor and ivacaftor
macrolide antibiotics (e.g., clarithromycin, erythromycin)
mifepristone
mitotane
modafinil
mycophenolate
octreotide
protein kinase inhibitors (e. g., ceritinib, dabrafenib, erlotinib)
retinoic acid medications (e.g., acitretin, etretinate, isotretinoin, tretinoin)
rifabutin
rifampin
St. John’s wort
seizure medications (e.g., carbamazepine, gabapentin, levetiracetam, phenytoin, rufinamide, topiramate)
thioridazine
tranexamic acid
warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

stop taking one of the medications,
change one of the medications to another,
change how you are taking one or both of the medications, or
leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2023. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Depo-Provera

Does a man die as soon as his head is cut off?

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Does the brain continue to live and perceive the surrounding world for a few more minutes after the head flies off the shoulders, as, for example, on the guillotine? The thought of being able to see one’s own headless body in anyone would cause a shudder, but there is considerable evidence that the head, separated from the body, remains in consciousness for some time. Where is the myth and where is the truth?

Rasmus Kragh Jakobsen

Does the brain continue to live and perceive the world for several minutes after the head instantly flies off the shoulders, as, for example, on the guillotine?

On Wednesday it was 125 years since the last execution by beheading in Denmark, and in connection with this, a terrible question came from a reader: Does a person die instantly when his head is cut off?

“I just once heard that the brain dies from blood loss only a few minutes after the head is cut off, that is, people executed, for example, on the guillotine, in principle, could “see” and “hear” the environment, although they were already dead. Is it true?” Annette asks.

The idea of being able to see one’s own headless body in anyone is shuddering, and in fact this question arose several hundred years ago, when the guillotine began to be used as a humane method of execution after the French Revolution.

The severed head turned red

The revolution was a real bloodbath, during which 14 thousand heads were chopped off from March 1793 to August 1794.

And it was then that the question that interested our reader was first raised – it happened in connection with the execution by guillotine of Charlotte Corday, a woman sentenced to death, who killed the leader of the revolutionaries Jean-Paul Marat.

After the execution, there were rumors that when one of the revolutionaries took her severed head out of the basket and slapped her face, her face contorted with anger. There were also those who claimed to have seen her blush from insult.

But could this really happen?

The brain can survive for a while

“She couldn’t blush anyway, as this requires blood pressure,” says professor of zoophysiology Tobias Wang from the University of Aarhus, where, among other things, he studies blood circulation and metabolism.

However, he cannot categorically rule out that the head was still conscious for some time after the beheading.

“The problem with our brain is that its mass is only 2% of the total body, while it consumes about 20% of energy. The brain itself does not have a store of glycogen (energy depot – approx. Videnskab), so as soon as the blood supply stops, it immediately ends up in the hands of the Lord, so to speak.

In other words, the question is how long the brain has enough energy, and the professor wouldn’t be surprised if it lasted at least a couple of seconds.

In his realm of zoology, there is at least one species of animal that is known to have a head without a body: reptiles.

Severed turtle heads can live for a few more days

On YouTube, for example, you can find frightening videos where the heads of snakes without a body quickly snap their mouths, ready to bite into the victim with their long poisonous teeth.

This is possible because reptiles have a very slow metabolism, so if the head is not damaged, then their brain can continue to live.

“The turtles stand out in particular,” says Tobias Wang, and talks about a colleague who was supposed to use the brains of the turtles for experiments and put the severed heads in the refrigerator, assuming they would die there, of course.

“But they lived for another two or three days,” says Tobias Wang, adding that this, like the question about the guillotine, raises an ethical dilemma.

“From an animal ethics point of view, the fact that turtles’ heads do not die immediately after they are separated from the body can be a problem.”

“When we need a turtle’s brain, and it doesn’t have to contain any anesthetics, we dip the head into liquid nitrogen, and then it dies instantly,” explains the scientist.

Lavoisier winked from the basket

Returning to us humans, Tobias Wang told the famous story about the great chemist Antoine Lavoisier, who was executed by guillotine on May 8, 1794.

“Being one of the greatest scientists in history, he asked his good friend, the mathematician Lagrange, to count how many times he would wink after his head was cut off.”

So Lavoisier was about to make his last contribution to science by trying to help answer the question of whether a person remains conscious after decapitation.

He was going to blink once a second, and, according to some stories, he blinked 10 times, and according to others – 30 times, but all this, as Tobias Vand says, unfortunately, is still a myth.

According to the historian of science William B. Jensen of the University of Cincinnati in the United States, the wink is not mentioned in any of the recognized biographies of Lavoisier, in which, however, it is written that Lagrange was present at the execution, but was in the corner of the square – too far away to fulfill his part of the experiment.

The severed head looked at the doctor

The guillotine was introduced as a symbol of a new, humanistic order in society. Therefore, rumors about Charlotte Corday and others were completely out of place and gave rise to a lively scientific debate among doctors in France, England and Germany.

The question was never satisfactorily answered, and it was raised again and again until 1905, when one of the most convincing experiments was made with human heads.

This experiment was described by the French doctor Beaurieux, who conducted it with the head of Henri Languille, sentenced to death.

As Boryo describes, immediately after the guillotining, he noted that Langil’s lips and eyes spasmodically moved for 5-6 seconds, after which the movement stopped. And when Dr. Boryo, after a couple of seconds, loudly shouted “Languille!”, The eyes opened, the pupils focused and looked intently at the doctor, as if he had awakened a person from sleep.

“I saw undeniably living eyes looking at me,” writes Boryo.

After that, the eyelids dropped, but the doctor again managed to wake the convict’s head, shouting out his name, and only on the third attempt nothing happened.

Not minutes, but seconds

This story is not a scientific report in the modern sense, and Tobias Wang doubts that a person can really be conscious for so long.

“I think a couple of seconds is really possible,” he says, and says that reflexes and muscle contractions may remain, but the brain itself suffers from enormous blood loss and falls into a coma, so that the person quickly loses consciousness.

This estimate is supported by a proven rule known to cardiologists, which states that during cardiac arrest, the brain remains conscious for up to four seconds if the person is standing, up to eight seconds if they are sitting, and up to 12 seconds when lying down.

As a result, we have not really clarified whether the head can retain consciousness after being cut off from the body: minutes, of course, are excluded, but the version about seconds does not look incredible.

And if you count: one, two, three, you will easily be convinced that this is enough to realize the surroundings, which means that this method of execution has nothing to do with humanity.

The guillotine became a symbol of a new, humane society

The French guillotine was of great symbolic importance in the new republic after the revolution, where it was introduced as a new, humane way of carrying out the death penalty.

According to Danish historian Inga Floto, who wrote the book A Cultural History of the Death Penalty (2001), the guillotine was a tool that showed “how the new regime’s humane attitude towards the death penalty contrasted with the barbarity of the former regime.”

It is no coincidence that the guillotine appears as a formidable mechanism with a clear and simple geometry, from which it exudes rationality and efficiency.

The guillotine was named after the physician Joseph Guillotin (J. I. Guillotin), who after the French Revolution became famous and praised for proposing to reform the system of punishment, making the law equal for all, and punishing criminals equally regardless of their status.

© flickr.com / Karl-Ludwig Poggemann Severed head of Louis XVI executed on the guillotine from the cruel practice of those times when an executioner with an ax or sword often had to deal several blows before he managed to separate the head from the body.

When, in 1791, the National Assembly of France, after a long debate about whether to abolish the death penalty altogether, decided instead that “the death penalty should be limited to the simple deprivation of life without any torture of the condemned”, Guillotin’s ideas were adopted.

This led to the improvement of the earlier forms of “falling blade” tools into the guillotine, which thus became a significant symbol of the new social order.

The guillotine was abolished in 1981

The guillotine remained the only execution tool in France until the death penalty was abolished in 1981 (!). Public executions were abolished in France in 1939.

Recent executions in Denmark

In 1882 Anders Nielsen Sjællænder, a farm worker on Lolland, was sentenced to death for murder.

On November 22, 1882, the only executioner in the country, Jens Sejstrup, brandished his axe.

The execution caused a great stir in the press, especially because Seistrup had to be hit with an ax several times before the head was separated from the body.

Anders Schelländer was the last person to be publicly executed in Denmark.

The next execution took place behind closed doors at Horsens Prison. The death penalty in Denmark was abolished in 1933.

Soviet scientists transplanted dog heads

If you can stand a little more horrifying and shuddering science experiments, watch a video that shows Soviet experiments simulating the opposite situation: severed dog heads are kept alive with an artificial blood supply.

The video was presented by the British biologist JBS Haldane, who said that he himself had carried out several similar experiments.

There were doubts whether the video was propaganda exaggerating the achievements of Soviet scientists. Nevertheless, the fact that Russian scientists were pioneers in the field of organ transplantation, including transplanting the heads of dogs, is a generally recognized fact.

These experiences inspired South African physician Christiaan Barnard, who became world famous for performing the world’s first heart transplant.

We thank our reader for the question and send her a Videnskab.dk T-shirt as a reward. We also thank our expert Tobias Wang for helping us shed light on this daunting topic. If you yourself want to ask a question to science, send it here: [email protected].

Meals before and during competitions

Spring is coming, which means the season of the long-awaited running competitions. Everyone sets different goals for themselves, but one thing is certain: everyone wants to achieve the best result that they are capable of, and to have fun at the same time. A significant role in this is played by how you eat before and during the race. It should be noted here that it is unlikely that it will be possible to significantly improve your result due to proper nutrition, because the technique of natural running includes many factors. But to significantly worsen it and spoil the overall impression of participating in the competition is as much as you like.

Therefore, it is important to observe a few simple principles.

Meals before the start

The day before the start, try to eat simple food, without any frills. This is especially true for those who have gone abroad and want to try something “that kind”. The usual breakfast, mostly carbohydrate lunch and dinner – these are your friends before the start. If you want to eat meat or fish, let it be a baked or boiled dish. Any spicy, heavily fried, smoked options put a load on the liver, and it is the energy station of the body. Please her on the eve of the start and you will feel a surge of strength.

On the morning of race day, you need complex (starchy) carbohydrates: porridge, toast, etc. You do not need a lot of protein, so you should not eat scrambled eggs, ham, etc. Also try to avoid a lot of sweets. A little jam on toast or a bun won’t hurt. However, remember that any sugars (including honey) quickly raise blood sugar levels, but the same drop (associated with a sharp release of insulin) can follow the peak of sugar levels, and if this moment comes at the time of the start, then you will experience weakness due to low glucose levels. The correct technique of natural running will help to level out such differences.

Also on the eve of the start, high-fiber foods (potatoes, vegetable salads, large amounts of fruit) should be avoided in order not to increase the volume of mass in the large intestine.

Meals during the competition

And then the starting shot rang out! When the euphoria of the first kilometers is over and the race becomes overcoming oneself, how to decide whether to eat according to the distance or be patient and leave the recovery for after the finish line? The answer to this question is best sought in training. Experiment with the longest workouts. As a rule, the body functions well for the first 45-60 minutes of continuous exercise, if you have the correct natural running technique. Next, he needs a drink. This is due to the fact that a person is not a machine. The car can be driven under the power limit until the fuel tank is empty, then fill it up and continue the race at the same speed. It happens differently in the body. When our reserves of glycogen, the source of “fast” fuel, remain less than half, the body begins to slowly save it, reducing the intensity of its mobilization from the depot in the liver and muscles.

In order to maintain the rate of glucose supply to working muscles, nutrition is needed along the distance. This is especially true for marathons, but can be useful for shorter distances as well. An approximate rule is the following: take the first energy gel 40-50 minutes after the start of the run and then 100-150 kcal every 20-25 minutes of the race.
There is now a huge variety of sports nutrition for use in the competition. The best advice for choosing, I think, is experimenting in training.

Each person is unique, including in their reaction to food. Especially taken in a state of submaximal physical activity. What is good for your friends may cause rejection of the same gel or bar in you. Therefore, in advance in training, try different gels, tastes to determine what suits you. Even the taste of the gel or drink is important, because. in difficult moments, the runner can simply refuse and throw away this hated viscous sweet gel. Be prepared for thoughts like: “… it’s so hard, and then squeeze
it, it is cloying, nasty, you still need to drink it down … ”, etc. Therefore, decide for yourself in advance or consult with the trainer at what marks you need to take food, and take the appropriate number of +1 gel sachets just in case.

Most gels should be taken with a few sips of water to improve absorption and digestion in the stomach. Arrange for yourself the last food station 5-6 km before the finish line, this will be enough to run at a brisk pace. Separately, it should be said about gels with caffeine. At a half marathon, you can take a pair of these for the second half of the distance. If you are at the start of a marathon, then you should not overload your body with caffeine for the first 2/3 of the race. Over-stimulating yourself can lead to speeding and increased energy expenditure by
the first half, which will negatively affect the second. Give yourself 2 marks for the distance where you will be taking caffeine-containing meals, for example, 25-27 km (when it gets hard for the first time) and 35-37 km (when you need to gather the last strength for the finish). Let the rest be ordinary food, so that you use your natural powers.

Food after the finish

And here is the long-awaited finish! The finish line, a well-deserved medal and the long-awaited finisher’s package: water, drink (and if you’re lucky, beer too ), fruit.