Depo-Provera: Contraceptive Risk?

Abstract

This writer agrees with Carol Levine that the issue involving depo-provera is both complex and confusing. Comment is offered on some of the conclusions reached by Levine in her article, "Depo-Provera and Contraceptive Risk: A Case Study of Values and Conflicts". In the discussion of risks and benefits, problems with administration of estrogens are rarely recommended for depo-provera users. The metabolic side-effects which are identified are also seen among oral contraceptive (OC) users and, with the exception of weight gain, appear to have a smaller impact than the combination oral steroids. Exception is taken with the description of delayed return of fertility as a "particularly serious side-effect," for delay in return appears to be a matter of months only. In regard to carcinogenicity, there is no statistically valid evidence of danger relating depo-provera to breast or cervical cancer in the human. Levine's article gives the impression that depo-provera is intended for poor women or "2nd class" citizens and this fails to accurately reflect what probably would occur were the drug available in the United States. This writer believes depo-provera to be a safer contraceptive method than the OC and to be more effective in practice.