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Depo-Provera injection - your questions answered

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Irregular bleeding after stopping the Depo-Provera injection
Q: I came off the Depo injection six months ago and was told not to expect periods for around six months to a year. Literally one month afterwards I had bleeding but this has been irregular spotting and at one stage bleeding every two weeks. In the last eight weeks I have had no bleeding whatsoever so I'm a little confused and wondered if this is a normal problem?
brit2001

A: Irregular bleeding can occur after stopping the Depo-Provera injection. Research suggests that women trying to conceive after stopping Depot Progestogen take at least four months longer to become pregnant compared with women stopping other methods of contraception (eg ten months instead of the average of six). In some cases, fertility may take up to a year or longer to return. As you are concerned, make an appointment to talk to the nurse or doctor who usually provides your contraceptive advice.

Will I know when my menopause has started?
Q: I am in my 40s and have been on the Depo-Provera injection for many years and personally think it's wonderful. However, without periods how will I know when I start the menopause, as I thought irregular periods were one of the main features? Also when will I know its perfectly safe for me to stop taking it without any risk of pregnancy?
Cassuis

A: You would usually expect to start getting symptoms due to lack of oestrogen when the menopause arrives. As the Depo injection does not contain oestrogens, it will not mask the usual hot flushes/night sweats that affect 75 per cent of menopausal women. If you are one of the 25 per cent of women who do not get significant menopausal symptoms, it can be difficult to know. Your doctor will usually suggest blood tests to check hormone levels at some stage (eg age 50), as he/she won't want to continue giving you unnecessary Depo injections. The average age for the menopause is 51 years. It is usually advised that you use contraception for one year after menopause.

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