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Maybe its just me, but it took quite some time to figure out what the drug does. I think in order to make the article clearer, someone needs to revamp the introduction and make it clearer. I would offer to, but this is way outside my knowledge. Sovereignlance ( talk) 07:07, 21 December 2011 (UTC)
I've noticed that the two "LaCroix" studies (probably more accurately Scholes studies, as Scholes is the lead author) are billed as being essentially one study on the talk page and in the article. I'm not clear why this is. Looking at the studies, they describe two different patient populations. One study looked at a group of 170 women aged 14-18, enrolled in 1999-2000 ( PMID 15699307). The other study looked at 457 women aged 18-39 ( PMID 12192229), enrolled 1994-1999. There's no overlap in the cohorts (see their ages), and they were enrolled separately (not as part of the same project). So these would appear to be two separate studies, which reached similar conclusions. I think the confusion may arise from a third study ( PMID 14759613), in which Scholes et al. "pre-published" their results from the adolescent cohort, but that study is not referenced in the article. The bottom line is that there appear to be two separate studies (one in adolescents, one in adult women) which reached similar conclusions about reversibility of BMD after discontinuation of Depo (in addition to the small New Zealand study). I'll make an adjustment to the text to reflect this. MastCell 03:29, 5 November 2006 (UTC)
Thank you, David. Points taken. Apologies to Cindery for being unnecessarily argumentative. To refocus on content issues, I'm curious to hear other opinions about labeling Lacroix a "Pfizer consultant" in the context of this article, as I notice I'm not the only editor to raise this concern. My own feeling is that it represents OR, as I mentioned above, again in needlessly incivil language for which I apologize. MastCell 03:35, 5 November 2006 (UTC)
i must add to this discussion since my mother was tricked into being injected with depo provera 28 years ago, in britain there where many foreign women also coerced and some even FORCED into being injected with provera - non of them knew depo would have such an awful affect to their health and neither i believe do all those pour women in thailand .
...i was breast fed soon after i was born so i too have had serious health problems since childhood ..some of these issues include low bone density since the age of about 6 ,my mother developed osteoarthritis soon after being given the depo injection ,however she was not on depo for a long time but still she developed these problems and so did i and many of the women also on depo-provera and the children born soon after to mothers on this drug....this is no mere coincidence and the medical world has consistently LIED about the dangers. there are thousands of women here in the u.k who have attempted to sue the drug company's ..my mother is one of them . whoever created this drug has a lot to answer for.
I suggest that this article have a section just for evidence about cancer risks. Why is item #9 in the "Footnotes" section blank? -- JWSchmidt 04:24, 5 November 2006 (UTC)
Just a question (from a random reader of course), when the trials were taking place for the Depo-Provera were any other variables taken into consideration? Such as other contraceptives being used with the depo-provera, surroundings, and the people being tested of course. Because if the first-year failure rate results were tested by only using the depo and nothing else, that would be quite impressive. — Preceding
unsigned comment added by
99.161.161.167 (
talk) 18:03, 6 August 2011 (UTC)
Just a question (from a random reader of course), when the trials were taking place for the Depo-Provera were any other variables taken into consideration? Such as other contraceptives being used with the depo-provera, surroundings, and the people being tested of course. Because if the first-year failure rate results were tested by only using the depo and nothing else, that would be quite impressive. — Preceding unsigned comment added by 99.161.161.167 (talk) 18:03, 6 August 2011 (UTC) — Preceding
unsigned comment added by
99.161.161.167 (
talk)
i can only assume the following claim is nonsense:
.
References
"The majority of this article has been written by a single editor who persistently and blatantly violates WP:NPOV, WP:NOR, and restores inaccurate information, using Wikipedia as a soapbox to push their POV that Depo-Provera (and most other contraceptives) are dangerous products foisted on women by a conspiracy of greedy and malevolent corporations, public health organizations and physicians. 68.255.20.88 08:05, 3 November 2006 (UTC)"
actually i would like to see that 'inaccurate inoformation' - at least in the discussion section - as well as Pfizers' completely accurate and neutral information —The preceding unsigned comment was added by 202.0.106.130 ( talk • contribs).
'Infants born to women exposed to Depo during pregnancy in one study had an 80% greater chance of dying in the first year of life'
does this mean something along the lines of: "while Depo is not injected during pregnancy, if it WERE injected due to error the consequences would be............"
or does it mean something else entirely????????? also the citataion does not re-direct to an actual article —The preceding unsigned comment was added by 202.0.106.130 ( talk • contribs).
is it reasonable to suggest in the article that while other contraceptives are only partially effective Depo is near 100% effective or is that not accurate? —The preceding unsigned comment was added by 202.0.106.130 ( talk • contribs).
'Infants born to women exposed to Depo during pregnancy in one study had an 80% greater chance of dying in the first year of life' and here is the citation:
Exposure to DMPA in pregnancy may cause low birth weight.
[No authors listed]
PIP: A study sponsored by the Special Program of Research, Development and Research Training in Human Reproduction of the World Health Organization was carried out in Thailand involving groups of women with 1573 accidental pregnancies. There were 830 accidental pregnancies while using the injectable contraceptive depot-medroxyprogesterone acetate (DMPA), while 743 women had become pregnant before use. There were also 601 accidental pregnancies in oral contraceptive (OC) users. The comparison group of a total of 2587 controls comprised women whose pregnancies were planned as opposed to the exposed group. Women using DMPA had more pregnancy risk factors compared to other groups owing to low socioeconomic status, lower maternal weight and height, smoking and alcohol use during pregnancy, and unplanned pregnancy. However, even after adjusting for these factors, DMPA users had a 50% higher than normal risk of having a low-birth-weight child. The same level of statistically not significant risk was also found among the OC users. Among those who had had accidental pregnancies during DMPA use, and in whom conception was estimated to have occurred within 4 weeks of a DMPA injection, the risk of low birth weight was 90% higher than that in the control group. The increase in risk appeared to decline to 50% when the interval between conception and DMPA injection was 5-8 weeks, and to 20% when the interval between conception and DMPA injection was 5-8 weeks, and to 20% when the interval was or= 9 weeks. This trend was highly significant. Early, high-dose exposure in utero to DMPA seemed to affect fetal growth. There was no increase in the risk of mortality in the 1st year of life for infants exposed to OCs as compared to infants not exposed. However, infants from DMPA-exposed pregnancies had an 80% higher than normal risk of dying during the 1st year of life. Therefore, some infants born out of accidental pregnancies that occur during DMPA use may be at an increased risk of infant death.
—The preceding unsigned comment was added by 202.0.106.130 ( talk • contribs).
according to Pfizers' site, which the section on Warnings and precautions is purportedly referfing to:
'You should use Depo-Provera Contraceptive Injection long term (for example, more than 2 years) only if other methods of birth control are not right for you.'
i have deleted those items which appear to be either gibberish or deliberate misinformation —The preceding unsigned comment was added by 202.0.106.130 ( talk • contribs).
how is the following NOT gibberish? 'Use of Depo may offer more privacy to some users than other forms of contraception, such as pills, condoms, and diaphragms, as there are no material objects which must be kept at home to continuously provide contraceptive protection.' —The preceding unsigned comment was added by 202.0.106.130 ( talk • contribs).
It's not really possible to quantify that, but it seems pretty obvious. How IS that gibberish? If you're using the normal use of gibberish to mean something that doesn't make any sense, I don't see your point. 71.63.119.49 01:13, 18 August 2007 (UTC)
sounds good however what is BMD and what is 'bone accretion'...... and who is the target audience?
References
Many parts of this article are good and NPOV, but other parts of it read like a scathing review. I'm sorry I don't have any better critcism at this time, but wow... this article seems to be highly POVed against use of Depo. I don't want to start disputing facts, or quotes, like where there's that quote that (paraphrased) Depo is by far the most dangerous drug on the market (/paraphrased). But it would be nice if the content outside of facts and quotes were more straight forward, honest, and neutral. I mean, the dangers that are inherent in use of Depo are pretty clear given the facts, I don't think we need to bolster that with our own personal opinions. -- Puellanivis 22:16, 4 December 2006 (UTC)
In general, I think the {{totally-disputed}} template and its ilk should be reserved for instances where no agreement or consensus can be reached on NPOV, despite the efforts of a number of editors. I don't think we're at that point yet - I'd suggest, instead, editing the three articles to try to remove what appears to be POV. It may be possible to do so and maintain a reasonable consensus. If not, and an impasse is reached, then the NPOV tags would be more appropriate - I just don't like to use them first-line, before we've made efforts to address the POV issues. So I guess what I'm saying is, be bold and edit the articles (or propose edits on the talk page) to address the POV issues. MastCell 18:21, 20 December 2006 (UTC)
Well, I guess whether you add the tag is up to you. I would say that if you add the tag, it would be best to list here on the talk page specific areas/issues which you believe are factually inaccurate or POV. Best of all is to also propose edits to resolve those issues). My experience has been that just tagging an article as POV, without specifying the reasons and particulars, is not as constructive. MastCell 21:57, 20 December 2006 (UTC)
I've removed the following from "Warnings and Precautions":
Some women may prefer amenorrhea. According to Jerilynn Prior, M.D., professor of endocrinology and metabolism at the University of British Columbia in Vancouver, and board member for the Society for Menstrual Cycle Research,"the most important thing to emphasize about menstrual suppression is that the long-term effects are simply unknown," and "allowing the one vital sign unique to women to go unmonitored...could ultimately lead to an enormous uncontrolled experiment with a woman's health." [1]
The "some women may prefer..." sentence is unsourced, and the quote on the importance of a menstrual cycle and the possbile risks of amenorrhea is in no way specific to Depo (it would apply equally to all forms of hormonal contraception) and is more appropriate for the hormonal contraception or amenorrhea articles. MastCell 18:32, 20 December 2006 (UTC)
References
The Contraindications section of this Wikipedia article used to only say:
The full prescribing information from Pfizer for Depo-Provera in the United States lists the following in its Contraindications section: [2]
The summary of product characteristics ( SPC) from Pharmacia ( Pfizer) for Depo-Provera in the United Kingdom and Europe says the following its Contraindications section: [3]
The WHO Medical Eligibility Criteria for Contraception [4] and the RCOG FFPRHC [5] UK Medical Eligibility Criteria for Contraception [6] have more informative annotated tables of relative (category 3) and absolute (category 4) contraindications for Depo-Provera than the list drawn from Pfizer's US-only full prescribing information and patient package insert.
Significantly, Pfizer's US-only label information lists "past history of thromboembolic disorders" as a contraindication to using Depo-Provera, whereas the UK and European SPC, the WHO and FFPRHC Medical Eligibility Criteria for Contraception, and current medical reference textbooks do not and even suggest progestogen-only contraceptives including Depo-Provera as alternatives to combined oral contraceptives containing estrogen for which a "past history of thromboembolic disorders" is an absolute (category 4) contraindication. [7]
It is also useful to distinguish contraceptive methods like Depo-Provera and other hormonal contraceptives where use during pregnancy is not indicated but accidental use has not been found to be harmful, from contraceptive methods like the IUD where use during pregnancy is an absolute (category 4) contraindication (because of the risk of serious pelvic infection and septic spontaneous abortion). [8]
The link to the WHO and FFPRHC Medical Eligibility Criteria for Contraception Progestogen-only contraceptive tables also provides easy comparison of injectable progestogen-only contraceptives including Depo-Provera with oral progestogen-only contraceptives ( minipills) and progestogen-only implants ( Norplant, Jadelle, Implanon) that explain why Depo-Provera has more relative (category 3) contraindications than progestogen-only minipills or implants: 1) Depo-Provera is long-acting and not rapidly reversible 2) Depo-Provera's relatively high progestogen dose suppressing follicular development and ovulation leads to a hypo-estrogenic state which may decrease protective HDL and could theoretically increase cardiovascular risk (though it has not been shown to do so)--which would be of most concern with women already at very high cardiovascular risk (such as those with a history of ischemic heart disease, stroke, complications of hypertension, or complications of diabetes).
If this Wikipedia article's Contraindication section is too long, perhaps:
69.208.162.137 20:54, 16 January 2007 (UTC)
I agree that the category numbers were superfluous, so I have removed them. I also removed "breastfeeding < 6 weeks postpartum" which is listed as a relative contraindication in the WHO MEC but not in the FFPRHC MEC, and is not listed as a contraindiction in the US prescribing information nor in the UK SPC. 69.208.162.137 04:54, 17 January 2007 (UTC)
I'm sorry, what were the grounds for attaching the "neutrality disputed" tag? Usually if there are issues, they're addressed here on the talk page and via edits. If they can't be resolved here, then the tag is attached. Could the placer of the tag comment on the POV issues, so that we can work on them? MastCell 21:31, 18 January 2007 (UTC)
Yes, please calm down and talk to us. Which parts do you consider shameful, intentional misrepresentations? We're reasonable folk. I don't think any of the regular editors here have a major pro- or anti-Depo axe to grind. Please assume the best, at least until proven otherwise. MastCell 22:36, 18 January 2007 (UTC)
69.208.168.135 17:46, 19 January 2007 (UTC)
OK... that's convincing. What would you propose changing the article text to say? MastCell 18:06, 19 January 2007 (UTC)
However, the potential benefits of Depo Provera in epilepsy and sickle-cell disease have been described in case reports and have not been studied in randomized controlled trials.
As with her description of the duration of reduced risk of endometerial cancer, I think the characterization in Westhoff's review article of "potential benefits" of Depo-Provera as having only been demonstrated in " case reports" is misleading and the further emphasis in this Wikipedia article of benefits not being based on a " randomized controlled trials" is even more misleading.
For the reduced risk of sickle cell crises, Westhoff cites 2 studies that found significant hematological and clinical benefits: 1) a 2-year placebo-controlled crossover trial completed by 23 patients and 2) a 1-year 3-way (DMPA, COCP, placebo) controlled trial with 43 women. They may not have been "randomized", but they were placebo-controlled trials, not "case reports".
For the reduced risk of seizures, Westhoff cites a 1-year clinical trial involving 14 women at the Yale Epilepsy Center, that was not placebo controlled, but was a "clinical trial," not a "case report."
Speroff & Darney, Hatcher, and Mishell all cite fewer sickle-cell crises and fewer seizures as significant, specific noncontraceptive health benefits of Depo-Provera without any qualifications implying the benefits are based on weak evidence that should be heavily discounted.
Of note, Darney, currently the chief of obstetrics & gynecology at UCSF's San Francisco General Hospital, co-wrote a JAMA article "Use of oral contraceptives by women with epilepsy"( PMID 3723710) with the lead authors (Mattson & Cramer) of the Yale DMPA study and should be the most knowledgeable of its significance among the review and textbook authors.
I would suggest omitting from this Wikipedia article the sentence:
and separating the benefits of reduced seizures and reduced sickle cell crises into separate bullet items:
I would also suggest changing:
to:
A decrease in symptoms of endometriosis was found in a clinical trial.([ PMID 8765259], cited in Westhoff's review article).
The decreased incidence of primary dysmenorrhea, ovulation pain and functional ovarian cysts are a direct result of the anovluation caused by Depo-Provera.
69.208.168.135 22:28, 19 January 2007 (UTC)
I think we do a disservice to women by stating that Depo is near 100% effective when for so may groups this is not really true. I changed the wording under Benefits to reflect this. I've also added some information about failure rates that explains what some users can expect based on the National Survey of Family Growth.
I notice that in the discussion of Breastfeeding that there is no mention of the fact that Depo Provera appears in the breast milk. Although this is thought to be safe, nursing moms might find this information important. Not all moms will feel comfortable exposing their newborn to unneeded artificial sex hormones. Other thoughts?
Can we remove it? Please? I'm not saying the article doesn't need more work, but what are the "neutrality" issues here? MastCell 17:27, 21 February 2007 (UTC)
After a quick glance, it appears the article as a whole potrays the manufacturer in an overly positive light. For example: "Other, less frequently reported adverse reactions are listed in the patient and physician label information for Depo-Provera." Why aren't these listed? Even if they are rare? Sounds a lot like a company line. — Manti core 11:30, 21 April 2007 (UTC)
Removed the following intentionally deceptive false and deliberately misleading statement:
that was based on the last paragraph of a deceptive and misleading section of a 22-year-old Multinational Monitor article, that said:
68.255.19.25 05:08, 22 February 2007 (UTC)
I've put in a request to move the article from here Depo Provera to Depo-Provera as that it how it is referenced throughout http://www.depoprovera.com/ I've changed the references within the article to reflect the change. -- MacAddct1984 14:34, 21 March 2007 (UTC)
I would like to treat this parameter the same on all the hormonal contraception articles. Please read my opinion and discuss this issue at Talk:Combined oral contraceptive pill#Weight parameter in infobox. Lyrl Talk C 21:30, 20 August 2007 (UTC)
"Likewise, users of Depo-Provera have reported a significantly decreased risk of contracting cervical cancer. Because of it's carcinogenic benefits to users, it is sometimes administered with or as a carcinogenic medication."
Medroxyprogesterone beefman ( talk) 07:06, 23 January 2009 (UTC)
Is DMPA FDA-approved for use in sex offenders? If not, perhaps this should be mentioned. beefman ( talk) 07:06, 23 January 2009 (UTC)
Can a note be included in the use for migraines? I don't expect it is FDA approved for this - but it has amazing results for some and should be more widely known for this so people don't have to suffer. Becky B-C ( talk) 22:45, 31 December 2009 (UTC)
I have removed text in the Warnings and Precautions section which stated "although one [study] notes that bone loss was not reversible in long-term users of Depo-Provera." None of the cited studies makes such a note. The one study (citation #36) which examined long-term users did not examine long-term users after they had discontinued using the drug. These long-term users were only studied while still taking the drug--thus it is not appropriate to conclude that the bone loss was not reversible. Rather, there is no information in the cited studies on bone-loss reversibility in these users.
If it is in fact true that there is a study showing irreversibility in long-term users, the citation needs to be updated to reflect the appropriate study. Without such an update, the unsupported claim should not be reinserted in the article. It was most likely originally based on an incomplete reading or understanding of the study in citation #36. 24.17.183.46 ( talk) 22:16, 19 September 2009 (UTC)
Why doesn't this article mention decreased sex drive caused by the use of depo?
Here's a quick source--just look on google for more:
http://answers.google.com/answers/threadview/id/785123.html —Preceding
unsigned comment added by
209.211.34.13 (
talk) 23:24, 11 October 2009 (UTC)
It's strange that this doesn't seem to be more widely talked about, because anecdotal evidence suggests this is incredibly common. Personally I felt awful when I tried it - no libido, flat mood, etc - and almost everyone I've ever spoken to about it seems to report adverse side effects like this (at the very least they felt a bit "weird", and most had reduced sex drive, mood problems, etc). Only one person I've ever had a conversation with about it said they were absolutely fine, and significantly she was not in a long term relationship, which I think would make many of these symptoms less obvious (low sex drive is less of a problem when you don't have a partner with a normal libido! And I've always found that when my moods are messed up, e.g. PMT, having a partner & children makes it so much more of a problem as they bear the brunt of it. If I lived alone I'd just sleep more & curl up on the sofa with chocolates!). I can't help but wonder if women are just not reporting these problems (I know I didn't) - it would be interesting to see how many people only ever have one injection & give up on it (does anyone know any statistics on this?); if there wasn't something that made them unhappy with the treatment you'd expect that most women would continue as it seems on the surface to be an ideal method of contraception! I do realise this comment doesn't contribute anything wildly significant to the discussion as it is only based on anecdote & personal experience, if I had the time I'd like to look into the evidence properly & edit the entry to reflect this, but I just don't have the time to do the thorough research I would want to do before making any edits about this. missdipsy ( talk) 11:16, 14 December 2012 (UTC)
This site: [ Youtube] has a video about this product. Agre22 ( talk) 14:07, 22 November 2009 (UTC)agre22
The article is weak about the depo-provera's use in chemical castration in men. Agre22 ( talk) 13:45, 29 December 2009 (UTC)agre22
It would be great if there were another page, or at least a redirect page, that wasn't dependent on the Depo Provera brand name for progestin-only injectable contraceptives. Something like the Combined injectable contraceptive or Contraceptive impant pages. Was trying to clean up some pages and remove brand names and redirect to types of contraceptives instead. Sorry, as a newbie can't really figure out how to do this myself. —Preceding unsigned comment added by Emhawkins ( talk • contribs) 07:56, 4 July 2010 (UTC)
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In an effort to reduce duplication. We should not have a separate article for each method of using this medication. It was simply a lot of duplication of content. Doc James ( talk · contribs · email) 23:13, 23 December 2016 (UTC)
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Maybe its just me, but it took quite some time to figure out what the drug does. I think in order to make the article clearer, someone needs to revamp the introduction and make it clearer. I would offer to, but this is way outside my knowledge. Sovereignlance ( talk) 07:07, 21 December 2011 (UTC)
I've noticed that the two "LaCroix" studies (probably more accurately Scholes studies, as Scholes is the lead author) are billed as being essentially one study on the talk page and in the article. I'm not clear why this is. Looking at the studies, they describe two different patient populations. One study looked at a group of 170 women aged 14-18, enrolled in 1999-2000 ( PMID 15699307). The other study looked at 457 women aged 18-39 ( PMID 12192229), enrolled 1994-1999. There's no overlap in the cohorts (see their ages), and they were enrolled separately (not as part of the same project). So these would appear to be two separate studies, which reached similar conclusions. I think the confusion may arise from a third study ( PMID 14759613), in which Scholes et al. "pre-published" their results from the adolescent cohort, but that study is not referenced in the article. The bottom line is that there appear to be two separate studies (one in adolescents, one in adult women) which reached similar conclusions about reversibility of BMD after discontinuation of Depo (in addition to the small New Zealand study). I'll make an adjustment to the text to reflect this. MastCell 03:29, 5 November 2006 (UTC)
Thank you, David. Points taken. Apologies to Cindery for being unnecessarily argumentative. To refocus on content issues, I'm curious to hear other opinions about labeling Lacroix a "Pfizer consultant" in the context of this article, as I notice I'm not the only editor to raise this concern. My own feeling is that it represents OR, as I mentioned above, again in needlessly incivil language for which I apologize. MastCell 03:35, 5 November 2006 (UTC)
i must add to this discussion since my mother was tricked into being injected with depo provera 28 years ago, in britain there where many foreign women also coerced and some even FORCED into being injected with provera - non of them knew depo would have such an awful affect to their health and neither i believe do all those pour women in thailand .
...i was breast fed soon after i was born so i too have had serious health problems since childhood ..some of these issues include low bone density since the age of about 6 ,my mother developed osteoarthritis soon after being given the depo injection ,however she was not on depo for a long time but still she developed these problems and so did i and many of the women also on depo-provera and the children born soon after to mothers on this drug....this is no mere coincidence and the medical world has consistently LIED about the dangers. there are thousands of women here in the u.k who have attempted to sue the drug company's ..my mother is one of them . whoever created this drug has a lot to answer for.
I suggest that this article have a section just for evidence about cancer risks. Why is item #9 in the "Footnotes" section blank? -- JWSchmidt 04:24, 5 November 2006 (UTC)
Just a question (from a random reader of course), when the trials were taking place for the Depo-Provera were any other variables taken into consideration? Such as other contraceptives being used with the depo-provera, surroundings, and the people being tested of course. Because if the first-year failure rate results were tested by only using the depo and nothing else, that would be quite impressive. — Preceding
unsigned comment added by
99.161.161.167 (
talk) 18:03, 6 August 2011 (UTC)
Just a question (from a random reader of course), when the trials were taking place for the Depo-Provera were any other variables taken into consideration? Such as other contraceptives being used with the depo-provera, surroundings, and the people being tested of course. Because if the first-year failure rate results were tested by only using the depo and nothing else, that would be quite impressive. — Preceding unsigned comment added by 99.161.161.167 (talk) 18:03, 6 August 2011 (UTC) — Preceding
unsigned comment added by
99.161.161.167 (
talk)
i can only assume the following claim is nonsense:
.
References
"The majority of this article has been written by a single editor who persistently and blatantly violates WP:NPOV, WP:NOR, and restores inaccurate information, using Wikipedia as a soapbox to push their POV that Depo-Provera (and most other contraceptives) are dangerous products foisted on women by a conspiracy of greedy and malevolent corporations, public health organizations and physicians. 68.255.20.88 08:05, 3 November 2006 (UTC)"
actually i would like to see that 'inaccurate inoformation' - at least in the discussion section - as well as Pfizers' completely accurate and neutral information —The preceding unsigned comment was added by 202.0.106.130 ( talk • contribs).
'Infants born to women exposed to Depo during pregnancy in one study had an 80% greater chance of dying in the first year of life'
does this mean something along the lines of: "while Depo is not injected during pregnancy, if it WERE injected due to error the consequences would be............"
or does it mean something else entirely????????? also the citataion does not re-direct to an actual article —The preceding unsigned comment was added by 202.0.106.130 ( talk • contribs).
is it reasonable to suggest in the article that while other contraceptives are only partially effective Depo is near 100% effective or is that not accurate? —The preceding unsigned comment was added by 202.0.106.130 ( talk • contribs).
'Infants born to women exposed to Depo during pregnancy in one study had an 80% greater chance of dying in the first year of life' and here is the citation:
Exposure to DMPA in pregnancy may cause low birth weight.
[No authors listed]
PIP: A study sponsored by the Special Program of Research, Development and Research Training in Human Reproduction of the World Health Organization was carried out in Thailand involving groups of women with 1573 accidental pregnancies. There were 830 accidental pregnancies while using the injectable contraceptive depot-medroxyprogesterone acetate (DMPA), while 743 women had become pregnant before use. There were also 601 accidental pregnancies in oral contraceptive (OC) users. The comparison group of a total of 2587 controls comprised women whose pregnancies were planned as opposed to the exposed group. Women using DMPA had more pregnancy risk factors compared to other groups owing to low socioeconomic status, lower maternal weight and height, smoking and alcohol use during pregnancy, and unplanned pregnancy. However, even after adjusting for these factors, DMPA users had a 50% higher than normal risk of having a low-birth-weight child. The same level of statistically not significant risk was also found among the OC users. Among those who had had accidental pregnancies during DMPA use, and in whom conception was estimated to have occurred within 4 weeks of a DMPA injection, the risk of low birth weight was 90% higher than that in the control group. The increase in risk appeared to decline to 50% when the interval between conception and DMPA injection was 5-8 weeks, and to 20% when the interval between conception and DMPA injection was 5-8 weeks, and to 20% when the interval was or= 9 weeks. This trend was highly significant. Early, high-dose exposure in utero to DMPA seemed to affect fetal growth. There was no increase in the risk of mortality in the 1st year of life for infants exposed to OCs as compared to infants not exposed. However, infants from DMPA-exposed pregnancies had an 80% higher than normal risk of dying during the 1st year of life. Therefore, some infants born out of accidental pregnancies that occur during DMPA use may be at an increased risk of infant death.
—The preceding unsigned comment was added by 202.0.106.130 ( talk • contribs).
according to Pfizers' site, which the section on Warnings and precautions is purportedly referfing to:
'You should use Depo-Provera Contraceptive Injection long term (for example, more than 2 years) only if other methods of birth control are not right for you.'
i have deleted those items which appear to be either gibberish or deliberate misinformation —The preceding unsigned comment was added by 202.0.106.130 ( talk • contribs).
how is the following NOT gibberish? 'Use of Depo may offer more privacy to some users than other forms of contraception, such as pills, condoms, and diaphragms, as there are no material objects which must be kept at home to continuously provide contraceptive protection.' —The preceding unsigned comment was added by 202.0.106.130 ( talk • contribs).
It's not really possible to quantify that, but it seems pretty obvious. How IS that gibberish? If you're using the normal use of gibberish to mean something that doesn't make any sense, I don't see your point. 71.63.119.49 01:13, 18 August 2007 (UTC)
sounds good however what is BMD and what is 'bone accretion'...... and who is the target audience?
References
Many parts of this article are good and NPOV, but other parts of it read like a scathing review. I'm sorry I don't have any better critcism at this time, but wow... this article seems to be highly POVed against use of Depo. I don't want to start disputing facts, or quotes, like where there's that quote that (paraphrased) Depo is by far the most dangerous drug on the market (/paraphrased). But it would be nice if the content outside of facts and quotes were more straight forward, honest, and neutral. I mean, the dangers that are inherent in use of Depo are pretty clear given the facts, I don't think we need to bolster that with our own personal opinions. -- Puellanivis 22:16, 4 December 2006 (UTC)
In general, I think the {{totally-disputed}} template and its ilk should be reserved for instances where no agreement or consensus can be reached on NPOV, despite the efforts of a number of editors. I don't think we're at that point yet - I'd suggest, instead, editing the three articles to try to remove what appears to be POV. It may be possible to do so and maintain a reasonable consensus. If not, and an impasse is reached, then the NPOV tags would be more appropriate - I just don't like to use them first-line, before we've made efforts to address the POV issues. So I guess what I'm saying is, be bold and edit the articles (or propose edits on the talk page) to address the POV issues. MastCell 18:21, 20 December 2006 (UTC)
Well, I guess whether you add the tag is up to you. I would say that if you add the tag, it would be best to list here on the talk page specific areas/issues which you believe are factually inaccurate or POV. Best of all is to also propose edits to resolve those issues). My experience has been that just tagging an article as POV, without specifying the reasons and particulars, is not as constructive. MastCell 21:57, 20 December 2006 (UTC)
I've removed the following from "Warnings and Precautions":
Some women may prefer amenorrhea. According to Jerilynn Prior, M.D., professor of endocrinology and metabolism at the University of British Columbia in Vancouver, and board member for the Society for Menstrual Cycle Research,"the most important thing to emphasize about menstrual suppression is that the long-term effects are simply unknown," and "allowing the one vital sign unique to women to go unmonitored...could ultimately lead to an enormous uncontrolled experiment with a woman's health." [1]
The "some women may prefer..." sentence is unsourced, and the quote on the importance of a menstrual cycle and the possbile risks of amenorrhea is in no way specific to Depo (it would apply equally to all forms of hormonal contraception) and is more appropriate for the hormonal contraception or amenorrhea articles. MastCell 18:32, 20 December 2006 (UTC)
References
The Contraindications section of this Wikipedia article used to only say:
The full prescribing information from Pfizer for Depo-Provera in the United States lists the following in its Contraindications section: [2]
The summary of product characteristics ( SPC) from Pharmacia ( Pfizer) for Depo-Provera in the United Kingdom and Europe says the following its Contraindications section: [3]
The WHO Medical Eligibility Criteria for Contraception [4] and the RCOG FFPRHC [5] UK Medical Eligibility Criteria for Contraception [6] have more informative annotated tables of relative (category 3) and absolute (category 4) contraindications for Depo-Provera than the list drawn from Pfizer's US-only full prescribing information and patient package insert.
Significantly, Pfizer's US-only label information lists "past history of thromboembolic disorders" as a contraindication to using Depo-Provera, whereas the UK and European SPC, the WHO and FFPRHC Medical Eligibility Criteria for Contraception, and current medical reference textbooks do not and even suggest progestogen-only contraceptives including Depo-Provera as alternatives to combined oral contraceptives containing estrogen for which a "past history of thromboembolic disorders" is an absolute (category 4) contraindication. [7]
It is also useful to distinguish contraceptive methods like Depo-Provera and other hormonal contraceptives where use during pregnancy is not indicated but accidental use has not been found to be harmful, from contraceptive methods like the IUD where use during pregnancy is an absolute (category 4) contraindication (because of the risk of serious pelvic infection and septic spontaneous abortion). [8]
The link to the WHO and FFPRHC Medical Eligibility Criteria for Contraception Progestogen-only contraceptive tables also provides easy comparison of injectable progestogen-only contraceptives including Depo-Provera with oral progestogen-only contraceptives ( minipills) and progestogen-only implants ( Norplant, Jadelle, Implanon) that explain why Depo-Provera has more relative (category 3) contraindications than progestogen-only minipills or implants: 1) Depo-Provera is long-acting and not rapidly reversible 2) Depo-Provera's relatively high progestogen dose suppressing follicular development and ovulation leads to a hypo-estrogenic state which may decrease protective HDL and could theoretically increase cardiovascular risk (though it has not been shown to do so)--which would be of most concern with women already at very high cardiovascular risk (such as those with a history of ischemic heart disease, stroke, complications of hypertension, or complications of diabetes).
If this Wikipedia article's Contraindication section is too long, perhaps:
69.208.162.137 20:54, 16 January 2007 (UTC)
I agree that the category numbers were superfluous, so I have removed them. I also removed "breastfeeding < 6 weeks postpartum" which is listed as a relative contraindication in the WHO MEC but not in the FFPRHC MEC, and is not listed as a contraindiction in the US prescribing information nor in the UK SPC. 69.208.162.137 04:54, 17 January 2007 (UTC)
I'm sorry, what were the grounds for attaching the "neutrality disputed" tag? Usually if there are issues, they're addressed here on the talk page and via edits. If they can't be resolved here, then the tag is attached. Could the placer of the tag comment on the POV issues, so that we can work on them? MastCell 21:31, 18 January 2007 (UTC)
Yes, please calm down and talk to us. Which parts do you consider shameful, intentional misrepresentations? We're reasonable folk. I don't think any of the regular editors here have a major pro- or anti-Depo axe to grind. Please assume the best, at least until proven otherwise. MastCell 22:36, 18 January 2007 (UTC)
69.208.168.135 17:46, 19 January 2007 (UTC)
OK... that's convincing. What would you propose changing the article text to say? MastCell 18:06, 19 January 2007 (UTC)
However, the potential benefits of Depo Provera in epilepsy and sickle-cell disease have been described in case reports and have not been studied in randomized controlled trials.
As with her description of the duration of reduced risk of endometerial cancer, I think the characterization in Westhoff's review article of "potential benefits" of Depo-Provera as having only been demonstrated in " case reports" is misleading and the further emphasis in this Wikipedia article of benefits not being based on a " randomized controlled trials" is even more misleading.
For the reduced risk of sickle cell crises, Westhoff cites 2 studies that found significant hematological and clinical benefits: 1) a 2-year placebo-controlled crossover trial completed by 23 patients and 2) a 1-year 3-way (DMPA, COCP, placebo) controlled trial with 43 women. They may not have been "randomized", but they were placebo-controlled trials, not "case reports".
For the reduced risk of seizures, Westhoff cites a 1-year clinical trial involving 14 women at the Yale Epilepsy Center, that was not placebo controlled, but was a "clinical trial," not a "case report."
Speroff & Darney, Hatcher, and Mishell all cite fewer sickle-cell crises and fewer seizures as significant, specific noncontraceptive health benefits of Depo-Provera without any qualifications implying the benefits are based on weak evidence that should be heavily discounted.
Of note, Darney, currently the chief of obstetrics & gynecology at UCSF's San Francisco General Hospital, co-wrote a JAMA article "Use of oral contraceptives by women with epilepsy"( PMID 3723710) with the lead authors (Mattson & Cramer) of the Yale DMPA study and should be the most knowledgeable of its significance among the review and textbook authors.
I would suggest omitting from this Wikipedia article the sentence:
and separating the benefits of reduced seizures and reduced sickle cell crises into separate bullet items:
I would also suggest changing:
to:
A decrease in symptoms of endometriosis was found in a clinical trial.([ PMID 8765259], cited in Westhoff's review article).
The decreased incidence of primary dysmenorrhea, ovulation pain and functional ovarian cysts are a direct result of the anovluation caused by Depo-Provera.
69.208.168.135 22:28, 19 January 2007 (UTC)
I think we do a disservice to women by stating that Depo is near 100% effective when for so may groups this is not really true. I changed the wording under Benefits to reflect this. I've also added some information about failure rates that explains what some users can expect based on the National Survey of Family Growth.
I notice that in the discussion of Breastfeeding that there is no mention of the fact that Depo Provera appears in the breast milk. Although this is thought to be safe, nursing moms might find this information important. Not all moms will feel comfortable exposing their newborn to unneeded artificial sex hormones. Other thoughts?
Can we remove it? Please? I'm not saying the article doesn't need more work, but what are the "neutrality" issues here? MastCell 17:27, 21 February 2007 (UTC)
After a quick glance, it appears the article as a whole potrays the manufacturer in an overly positive light. For example: "Other, less frequently reported adverse reactions are listed in the patient and physician label information for Depo-Provera." Why aren't these listed? Even if they are rare? Sounds a lot like a company line. — Manti core 11:30, 21 April 2007 (UTC)
Removed the following intentionally deceptive false and deliberately misleading statement:
that was based on the last paragraph of a deceptive and misleading section of a 22-year-old Multinational Monitor article, that said:
68.255.19.25 05:08, 22 February 2007 (UTC)
I've put in a request to move the article from here Depo Provera to Depo-Provera as that it how it is referenced throughout http://www.depoprovera.com/ I've changed the references within the article to reflect the change. -- MacAddct1984 14:34, 21 March 2007 (UTC)
I would like to treat this parameter the same on all the hormonal contraception articles. Please read my opinion and discuss this issue at Talk:Combined oral contraceptive pill#Weight parameter in infobox. Lyrl Talk C 21:30, 20 August 2007 (UTC)
"Likewise, users of Depo-Provera have reported a significantly decreased risk of contracting cervical cancer. Because of it's carcinogenic benefits to users, it is sometimes administered with or as a carcinogenic medication."
Medroxyprogesterone beefman ( talk) 07:06, 23 January 2009 (UTC)
Is DMPA FDA-approved for use in sex offenders? If not, perhaps this should be mentioned. beefman ( talk) 07:06, 23 January 2009 (UTC)
Can a note be included in the use for migraines? I don't expect it is FDA approved for this - but it has amazing results for some and should be more widely known for this so people don't have to suffer. Becky B-C ( talk) 22:45, 31 December 2009 (UTC)
I have removed text in the Warnings and Precautions section which stated "although one [study] notes that bone loss was not reversible in long-term users of Depo-Provera." None of the cited studies makes such a note. The one study (citation #36) which examined long-term users did not examine long-term users after they had discontinued using the drug. These long-term users were only studied while still taking the drug--thus it is not appropriate to conclude that the bone loss was not reversible. Rather, there is no information in the cited studies on bone-loss reversibility in these users.
If it is in fact true that there is a study showing irreversibility in long-term users, the citation needs to be updated to reflect the appropriate study. Without such an update, the unsupported claim should not be reinserted in the article. It was most likely originally based on an incomplete reading or understanding of the study in citation #36. 24.17.183.46 ( talk) 22:16, 19 September 2009 (UTC)
Why doesn't this article mention decreased sex drive caused by the use of depo?
Here's a quick source--just look on google for more:
http://answers.google.com/answers/threadview/id/785123.html —Preceding
unsigned comment added by
209.211.34.13 (
talk) 23:24, 11 October 2009 (UTC)
It's strange that this doesn't seem to be more widely talked about, because anecdotal evidence suggests this is incredibly common. Personally I felt awful when I tried it - no libido, flat mood, etc - and almost everyone I've ever spoken to about it seems to report adverse side effects like this (at the very least they felt a bit "weird", and most had reduced sex drive, mood problems, etc). Only one person I've ever had a conversation with about it said they were absolutely fine, and significantly she was not in a long term relationship, which I think would make many of these symptoms less obvious (low sex drive is less of a problem when you don't have a partner with a normal libido! And I've always found that when my moods are messed up, e.g. PMT, having a partner & children makes it so much more of a problem as they bear the brunt of it. If I lived alone I'd just sleep more & curl up on the sofa with chocolates!). I can't help but wonder if women are just not reporting these problems (I know I didn't) - it would be interesting to see how many people only ever have one injection & give up on it (does anyone know any statistics on this?); if there wasn't something that made them unhappy with the treatment you'd expect that most women would continue as it seems on the surface to be an ideal method of contraception! I do realise this comment doesn't contribute anything wildly significant to the discussion as it is only based on anecdote & personal experience, if I had the time I'd like to look into the evidence properly & edit the entry to reflect this, but I just don't have the time to do the thorough research I would want to do before making any edits about this. missdipsy ( talk) 11:16, 14 December 2012 (UTC)
This site: [ Youtube] has a video about this product. Agre22 ( talk) 14:07, 22 November 2009 (UTC)agre22
The article is weak about the depo-provera's use in chemical castration in men. Agre22 ( talk) 13:45, 29 December 2009 (UTC)agre22
It would be great if there were another page, or at least a redirect page, that wasn't dependent on the Depo Provera brand name for progestin-only injectable contraceptives. Something like the Combined injectable contraceptive or Contraceptive impant pages. Was trying to clean up some pages and remove brand names and redirect to types of contraceptives instead. Sorry, as a newbie can't really figure out how to do this myself. —Preceding unsigned comment added by Emhawkins ( talk • contribs) 07:56, 4 July 2010 (UTC)
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In an effort to reduce duplication. We should not have a separate article for each method of using this medication. It was simply a lot of duplication of content. Doc James ( talk · contribs · email) 23:13, 23 December 2016 (UTC)