Sustained Release Hormone v Depot Hormone, Not All Progesterone Contraception is Created Equally

Sydney Botanical Gardens Venus Fly Trap
Deop-Provera, DMPA as it's known to gynos, is given as a shot of progesterone, but it is not a sustained release of progesterone hormone, like the constant leak of hormone out of the Implanon device, it is a depot. When you have a depot injection blood levels have peaks and troughs. Physiologically there are lots of differences in the progesterone only methods. With DMPA you get a suppression of your LH surge. You do not get a suppression of the FSH, so there is follicle development, and some low levels of estrogen are maintained. Usually we think of the estrogen levels as what will affect the liver's SHBG as we've discussed in posts about pills and other posts about DMPA. Male hormone side effects is what we were concerned with in that post, and the effects are different between different methods, and different between individuals as well. We know that the levonorgesterel in pills has a highter affinity for SHBG than does the progesterone in Implanon. The provera's effect (medroxyprogesterone actetate to those that like the scientific names) is a bit different still. And if you stuck your shot in a place massaged by daily activities you may find that the levels (if you could watch such things) vary even more! And though some studies, and some recent monkey studies didn't show any weight gain, we do always want to know what our body is doing with the weight we carry. One report that is now almost a couple of years ago showed that DMPA users gained fat, not just more muscle. Three years in the users gained 11 pounds, 9 of it fat. Probably what fat you get will be in your midsection. And if ovulation supression is what you are seeking for protection against ovarian cancer, only studies with oral contraception have actually showed that this is possible. Patients should be more protected from ovarain cancer with dMPA than by not contracepting, based on what we know about the physiology, but no studies have been done to document this so far.


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