amenorrhoea associated with Depo Provera has raised concerns about oestrogen deficiency diseases, especially osteoporosis - however ".. studies suggest that there is little cause for concern" (1)
amenorrhoea does not indicate hypo-oestrogenism - oestrogen follicular activity may still result in adequate oestradiol levels
the measurement of oestradiol levels in women using Depo Provera should only be considered if either,
women have symptoms of hypo-oestrogenism e.g. hot flushes, vaginal dryness, or,
women have been using this form of contraception for five years or more (with or without amenorrhoea)
oestradiol levels are not indicated if either,
the woman wishes to change her form of contraception anyway, or,
the woman wishes to continue using Depo Provera despite the result
if a woman wishes to consider changing from using Depo Provera if the level of oestradiol were low then
the oestradiol level should be measured directly before the next Depo Provera injection is due - if the oestradiol level is 100pmol/l or less then a repeat oestradiol level should be taken directly before the next injection is due. If again the result is 100 pmol/l or below then an alternative method of contraception should be discussed
delay in return to fertility
mean return to fertility with Depo Provera is 5.5 months
about 60% of women conceive within 12 months of discontinuation of Depo-Provera (85% within 24 months)
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