Pregnancy and Depo Provera?

December 7, 2007 10:41 AM

If you're on Depo Provera, how can you tell if you're pregnant?

This seems like a completely asinine question and I apologize if the answer is obvious...

But. No method of contraception is 100% effective, etc... so in the 0.1% case where Depo actually fails and you become pregnant, how can you tell, short of using a home pregnancy test monthly (Ouch! Expensive!) or just waiting till your next period (or not)?

Thanks!

posted by anonymous to health (25 comments total)

I'm not sure how your question is specific to Depo Provera users. If you're on Depo Provera, you can find out if you're pregnant the same way anyone else does: pregnancy test (or missing your period, then pregnancy test).
posted by amro at 10:45 AM on December 7, 2007

I wonder about this too. I was wondering if the OP doesn't usually have periods (some birth control can take them away entirely). I thought about switching to a birth control pill that eliminated periods or gave you one every four months or so, but I think I would freak out all the time worrying I was pregnant. How DO you know? Pregnancy tests are expensive. Sadly, however, I don't think there is an answer besides that.
posted by agregoli at 10:47 AM on December 7, 2007

Depo Provera users usually don't get their period except occasional spotting - it is very different from regular bc pills where you get a fake period every 4 weeks.

For the OP, if you are worried about an unexpected pregnancy, I would recommend using a form of backup protection, like spermicidal foam or even condoms.
posted by tastybrains at 10:51 AM on December 7, 2007

In the meantime, pregnancy tests really aren't *that* expensive if you are concerned - it's worth the peace of mind.
posted by tastybrains at 10:51 AM on December 7, 2007

DP is injected every three months, right? So does the doctor do a blood test for pregnancy prior to injecting it?
posted by amro at 10:53 AM on December 7, 2007

I'm not sure how effective they are (though my now pregnant wife has had incorrect results on expensive pregnancy tests), but there are really really cheap (say a few dollars) pregnancy tests available. Try a chain store or a big box retailer for the single use store brand.
posted by drezdn at 10:57 AM on December 7, 2007

No, Depo is so effective you don't have a test when you get your next shot unless you are late for the shot.

If not getting a period flips you out, Depo is not for you. You know your not pregnant because you are on the shot and the shot works. You should only be worried if you don't follow the specifications your dr gives you as far as when you can have sex after the first shot and how often you go back in for the shot.

I was on Depo for over a decade, I didn't have a period for over a decade. However, now I have a 10x risk of fracture in my lower verterbrae, they don't really let you stay on it for long anymore. As an early adopter, I kind of got the short end of that stick.
posted by stormygrey at 10:59 AM on December 7, 2007 [1 favorite]

I was on Depo Provera for a couple years in high school. There was literally no way for me to tell. Didn't get a period at all, only sometimes got slight cramps around that time that I would usually get a period. Only a couple times when I felt sorta funny did I take a pregnancy test just to be sure. They were always negative. As the above posters say, pregnancy tests are cheap. If you're thinking about it, just take one.
posted by heavenstobetsy at 10:59 AM on December 7, 2007

Really, if you are concerned about birth control failure, the best thing to do is pee on a stick once every 30 days. Short of a monthly blood draw, or waiting for labour to start, that's pretty much the only option.

Happily, pregnancy tests are dirt cheap. The ones you can buy at a Dollar Store in the US are both accurate and really popular with women who are TTC (trying to conceive) and peeing on sticks several days a month - sometimes several times a day.

SaveOnTests.com is also good for buying online; tests are 41 cents each, so for ten bucks you can pee on a stick once every 30 days for two years. These tests work every bit as well as the fancier drug store ones, and are probably what your healthcare practitioner is using when she asks you to pee in a cup.

Bargain basement peace of mind!
posted by DarlingBri at 10:59 AM on December 7, 2007

IANAD, but I kept an eye out for the following: tender breasts, excessive fatigue, repeat heartburn/nausea and deep mood swings, stronger than normal hormone fluctuations and nesting. If you begin to experience most of the above, and you're concerned, then take a pregnancy test. I was on it for three years and never really had a problem with any of these symptoms, until I stopped the birth control and got pregnant. As always, though, every single person's body is different.

Also, talk to your doctor/nurse practitioner. Most of the nurses, etc., in an OB/GYN office have experience with the different medicines and have heard a lot of patients' stories as well.
posted by mitzyjalapeno at 11:02 AM on December 7, 2007

According to Rxlist.com, "If the time interval between injections is greater than 13 weeks, the physician should determine that the patient is not pregnant before administering the drug. The efficacy of DEPO-PROVERA CI depends on adherence to the dosage schedule of administration."

OP, maybe you can get access to this paper?
posted by xo at 11:03 AM on December 7, 2007

are probably what your healthcare practitioner is using when she asks you to pee in a cup.

I've never looked into the relative merits of different test kits, but our NHS trust, who are very cost conscious, use Clearview. I would assume there must be a definite advantage in either specificity (i.e. false positive rate) or sensitivity (i.e. false negative rate) or both.

There are other signs of pregnancy besides no periods: swollen tender breasts, fatigue, nausea, urinary frequency. However in general depo-provera is considered more effective than sterilization or a regular copper coil, so if it were me I wouldn't be worrying, or using regular pregnancy tests "just in case".
posted by roofus at 11:10 AM on December 7, 2007

pregnancy tests are really not that expensive. you can get ANSWER 2 tests for $11.19 at CVS.com, which means that if you were to check every month, you'd have to pay $67.14 per year for your peace of mind.
posted by barrakuda at 11:29 AM on December 7, 2007

I was on Depo for 5 years. As others said, its really not for you if you're going to worry about being pregnant when you don't have a period. Occassionally, when I switched docs they would have me do a pregnancy test before the shot, and I supposed that if you're committed to depo as well as being a worrywart, then you could just ask the doc to do a pee test every time before your next shot.

Ugh, now that I'm on the pill I worry all the time because I'm not good at taking it at the exact same time everyday. Depo, in that sense, was a walk in the park.
posted by wuzandfuzz at 11:30 AM on December 7, 2007

I've never looked into the relative merits of different test kits, but our NHS trust, who are very cost conscious, use Clearview. I would assume there must be a definite advantage in either specificity (i.e. false positive rate) or sensitivity (i.e. false negative rate) or both.

Or, do they get them for free? Our hospital and doctors always use Pampers diapers, just because I think they must either get them for free (free advertising for Pampers) or at a severely reduced rate.

As for answering the question, I'd think any of the usual signs of symptoms out side of getting your period would tip you off to pregnancy - tender breasts, perhaps nausea, etc. This site has some good early pregnancy signs and symptoms.
posted by Sassyfras at 11:37 AM on December 7, 2007

I've never looked into the relative merits of different test kits...

Oh, let me introduce you to PeeOnAStick.com! I defy the NHS to have done more extensive research and testing than the women at the whacky world of POAS. Seriously.

I would assume there must be a definite advantage...

Clearview is only available to hospitals or medical practices; they don't sell to the public as far as I know. They have a stated sensitivity of 25mlU/ml. The Early-Pregnancy-Tests.com line has a sensitivity if 20, so at 91 cents each, they're probably the cheapest test for the highest accuracy you can get on the consumer market.

If you're doing one a month for peace of mind, the buck may be worth it. If you're doing 6 a month because you're insane, you're better off with the slightly less sensitive 41 cents ones. And you can sit next to me.
posted by DarlingBri at 11:40 AM on December 7, 2007

I have a Mirena IUD, which also causes amenorrhea. I tested every two months for a while after my periods stopped (and I wish I'd known I could get tests so cheaply!) but now that I feel secure, I'd only test if I started noticing symptoms like mitzyjalapeno lists above.
posted by moonlet at 11:48 AM on December 7, 2007

... my point being, eventually you get secure enough to trust it. If you don't, it's the wrong birth control method for you.
posted by moonlet at 11:50 AM on December 7, 2007

Y'all I don't think the question was "how do you like depo?" or "how effective is it?". The question was "how do you know if you're pregnant?".
posted by radioamy at 12:17 PM on December 7, 2007

This prior answer iby stormygrey s completely correct:
You know your not pregnant because you are on the shot and the shot works.

I was on Depo Provera for many years. I once had a pregnancy scare - I told the doctor I was pukey in the morning, very tired all the time, and only wanted to eat mac and cheese or cocktail olives. He laughed me out of the room. A pee test confirmed I was NOT pregnant, and it later turned out I was just drinking too much (and living on mac and cheese and cocktail olives), thus strung out, hungover, etc.

Anyway, when I found out I was pregnant a couple months ago honestly all the other symptoms hit me over the head before I later said "ooch, I'm a week late!". I was really emotional (way more caring than normal, but also hair trigger to be offended), and everyone told me my tits looked fabulous. The conclusion was arrived at long before the late period. Many women continue to get their periods through the first month or so of pregnancy - enough that the combination that "lateness" is an imperfect predictor and you are very unlikely to be the 1/100 women per year who gets pregnant on Depo Provera, is pretty confidence-inspiring.

(To me anyway).
posted by bunnycup at 3:15 PM on December 7, 2007 [1 favorite]

barrakuda, to me that's expensive when it's on top of birth control costs.
posted by agregoli at 3:25 PM on December 7, 2007

Periods should not be the be-all-end-all indicator of periods. Some people spot throughout their pregnancies, and some have implantation bleeding (when the egg implants in the uterine wall, it can sometimes leak a little bit of "blood"). There are much better signs, like nausea, tender breasts, etc.

I know that the Planned Parenthood in Mass uses the one dollar tests (or about that much). My friend stole a tube of them.
posted by nursegracer at 6:06 PM on December 7, 2007

Those home pregnancy tests are usually not reliable much before 5.5 weeks, so even if you took a monthly test you're looking at detecting the pregnancy (if any) that started more than 5.5 weeks ago, i.e., in the month preceding last month.

Otherwise it's no different than someone who's not on Depo, except that Depo is one of the more reliable methods of birth control so you'll be way less likely to be pregnant.
posted by ikkyu2 at 6:39 PM on December 7, 2007

When I was on Depo I had most of the symptoms that people are giving as pregnancy indicators, and it was just because Depo was a really bad fit for me. Please don't freak out just because you get moody or have tender breasts or whatever.

I don't know how the price compares to some of these online ordering places people are recommending, but I saw bulk-packs of pregnancy tests last time I was at CostCo. I'm sure Sam's Club or BJs or your local warehouse club store would have them, too, if you can find a friend with a membership to take you shopping.
posted by vytae at 8:13 PM on December 7, 2007

nursegracer has a good point about the confusing aspects of bleeding during pregnancies. My mom seems to have the strangest medical luck in the world, and during one of her pregnancies she had a full-on period for six months. She was obviously pregnant, and she was obviously having a period, and her doctor couldn't explain it. I've never heard of anyone else experiencing that, but she did, so I guess anything is possible.

I think once you get settled on Depo, you won't have any reason to worry. If I were you and I were really very concerned, I would take a pregnancy test just before you go to get each shot. Buy it at the dollar store, as ikkyu2 suggested. If you test with el-cheapo tests 4 times a year, you'd probably be spending a max of $20 a year. Good luck!

I never knew anyone who had any bad experiences on Depo. If you're really worried, talk to your doctor. You're supposed to be on birth control (I assume) to eliminate any worry about an unexpected pregnancy. If you're still worrying, then you need to find out some more info on your plan before you move any further.
posted by mitzyjalapeno at 8:56 AM on December 9, 2007