[NP-Clinical] Depo Provera, long term use, withdrawal?

[Barbara C. Phillips]

I'm seeing a 42 year old woman who has been on Depo for the last 14 years.
Initially she used it for contraception and found that it's been great at
getting rid of her PMS. For the last 8 months, I've been talking to her
about the long term effects of Depo on her bones. She does not care. Every
time it's time for a shot, she's insisting her moods become bad, her lower
abdomen becomes tender as well as her breast. She states that even her
coworkers say to her that it must be time for her "shot" because of her
mood.  She is literally begging me to continue giving her Depo - even wants
to sign a release, saying it's her choice to continue getting it.  A DEXA is
out of the question for her due to finances/insurance. Oh yeah.she smokes
too.

 

I've never had any woman on long term depo experience these "withdrawal"
symptoms before like she is. I have had one case of early osteoporosis that
appears to be related to Depo. What are you advising women when it comes to
long term depo use?

 

Thanks,

 

Barbara C. Phillips, NP

 

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