Request For Progestin-Only Birth Control Shots Form printable pdf download

Request For Progestin-Only Birth Control Shots Form

REQUEST FOR PROGESTIN-ONLY BIRTH CONTROL SHOTS

(DEPO PROVERA)

What are progestin-only birth control shots?

Progestin-only shots, such as Depo Provera, contain the hormone progestin, which works to

prevent pregnancy. Unlike other types of birth control shots, Depo Provera contains no

estrogen. To prevent pregnancy, a shot is given every 12 weeks.

How does Depo Provera work?

Depo Provera contains a hormone that prevents the ovary from releasing an egg. Depo Provera

is injected into the arm or buttock muscle (rear end), where it dissolves slowly and is released

into the body over time.

Depo Provera works very well to prevent pregnancy. For every 100 women using Depo Provera,

3 women per year will get pregnant.

Depo Provera may not work as well to prevent pregnancy if you are also taking certain kinds of

medication. Always let your healthcare provider know about any medications you are taking.

Who can use Depo Provera?

Women of any reproductive age can use Depo Provera, except women who:

- are pregnant;

- have had breast cancer;

- have a current history of blood clots;

- have a history of heart disease or stroke;

- have unexplained vaginal bleeding; or

- have liver tumors, active hepatitis, jaundice, or severe cirrhosis.

If you have a history of depression, talk to your healthcare provider. Depo Provera may not be

right for you.

If you are a teen and you decide to use Depo Provera, we suggest that you to talk to your family

about it.

What are the risks of using Depo Provera?

Use of Depo Provera may cause you to lose calcium stored in your bones. If you use

Depo Provera for more than two years, the loss of calcium may increase your risk of

osteoporosis and broken bones, particularly after you menopause. Calcium intake and exercise

should be addressed if you are receiving Depo Provera.

What are the side effects of Depo Provera?

The most common side effects are changes to your periods. Although these changes are not

always the same for every woman, almost all women who use Depo Provera experience some

changes. Irregular bleeding and spotting are common during the ﬁ rst few months of use.

Request For Progestin-Only Birth Control Shots Form