Turning Off Libido
Just how many women are affected by loss of libido is unclear. Pharmacia, the drug company that markets Depo-Provera, says that between one percent and five percent (1 in 20) of the users experience "decreased sexual desire," as they benignly describe the side effect.
But an Australian study said that one of the most common side effects of the drug was "dyspareunia" (meaning painful sex) or loss of libido, which affected eight percent (1 in 12) of the women.
One Internet survey conducted by a woman in Great Britain suggests that loss of sexual desire is common among women who have complaints.
Teresa Campbell solicited responses from more than 3,000 users of Depo-Provera and copyrighted the results. Campbell complains about serious side effects from Depo-Provera herself, so those attracted to her survey undoubtedly tend to have worries about the drug.
The number one complaint was weight gain (68%), but the number two complaint was loss of libido.
Nearly six out of ten women (58%) complained of it. The number three and four complaints were aggression (56%) and depression (54%).
Among those new to the drug (less than three months), complaints of depression, aggression and loss of libido were even higher than complaints of weight gain.
The Hormone Doctor
Dr. John Lee, a medical doctor and author of two best-selling books on female hormones, believes that Depo-Provera has adverse affects on the sexuality of nearly every woman.
"It's given to sex offenders as a chemical castration to kill their sex appetite," Lee said. He sees that as a hint about what it does to women. "Depo-Provera is the worst possible way to provide birth control. It's a long-term continuous release form of Provera. It lasts three months. There's a terrible incidence of side effects and it should not be used."
Dr. Lee, author of What Your Doctor May Not Tell You About Menopause, was a physician in general practice in the mid-1970s when he became interested in the effect on women of the hormone progesterone. Progesterone is one of three hormones controlling sexuality, the others being estrogen and testosterone.
Lee pointed out that Depo-Provera is synthetic progesterone. "Provera is a terrible thing," Lee said.
He complained that the drug companies take natural progesterone, change the molecule so that it can be patented, and then sell the synthetic as if it were as good as the real thing. Lee believes the change in the molecule is what leads to the drug's side effects.
Dr. David Zava, a biochemist with ZRT Laboratory in Portland, Oregon, who specializes in hormonal research, agrees with Lee. He describes progesterone as a "master key" that unlocks about ten different bodily functions. "Depo-Provera has a limited function and only opens about two of them," Zava says.
Zava says the synthetic progesterone does some things well, such as shut down the ovaries, which creates one set of side effects, and it does other things very poorly. He says Depo-Provera does not provide natural progesterone's calming effect in the brain nor its stabilizing effect on the cardiovascular system. "Women feel rotten on it," Zava says.
"Get a Physician's Desk Reference and look up Provera," Lee says. "You'll see there's about six columns of side effects. And it really doesn't have any benefits."
When Weight Gain Is the Least of Your Worries
Pharmacia acknowledges a number of potential side effects, the most prominent of which is weight gain. The company says women who remain on Depo for one year gain an average of five pounds. They gain eight pounds in two years. Six years adds 16 pounds.
Dr. Jerilynn Prior, a professor of medicine at the University of British Columbia in Vancouver, said that doses of progesterone actually raise core temperatures of the body and increase the number of calories a person can eat by about 300 per day.
But high-dose Depo-Provera may cause a reverse effect by shutting down the ovaries, where estrogen and testosterone are produced.
Lee and Zava believe Depo-Provera creates a hormonal imbalance in the body so estrogen becomes the dominant hormone. Subsequent weight gain is not the woman's fault, Lee maintains.
Depo-Provera is also known to cause irregularities in menstrual bleeding for most women. Repeated injections of the drug often stop women from having periods at all.
According to Pharmacia's literature, the drug has also been associated with complaints of headaches, breast swelling and tenderness, decreased sexual desire, depression, bloating, swelling of the hands and feet, nervousness, abdominal cramps, dizziness, weakness of fatigue, leg cramps, nausea, vaginal discharge or irritation, backache, insomnia, acne, pelvic pain, lack of hair growth or excessive hair loss, rashes, hot flashes and joint pain.
The drug company says a few women also complained of convulsions, jaundice, urinary tract infections, allergic reactions, fainting, paralysis, osteoporosis, lack of return to fertility, deep vein thrombosis, pulmonary embolus, breast cancer or cervical cancer.
The list of possible side effects for Depo-Provera seems almost ludicrous.
This is a drug given to millions of women. Men rip off the condom because sex won't feel as good for the next twelve minutes or so. But millions of women take a drug that may make them feel horrible all the time.
Depo-Provera and Murder
Some women blame Depo-Provera for sending them to the deepest depths of depression and even psychosis. Constance Lynn Baugh was jailed last February in St. Clair County, Illinois, on a charge of murdering her newborn baby. She's now awaiting trial.
Baugh's mother, Nancy Hedrick, believes Depo-Provera played a significant role in what happened. Baugh had a child at age 17 and immediately went on Depo-Provera to prevent another pregnancy. The drug is known to be more than 99 percent effective at preventing pregnancy, but it's not perfect.
Medical records show that even though Baugh maintained her shots every three months for the next two years, she got pregnant again in the summer of 2000.
However, Hedrick says that Baugh continued to deny being pregnant, even to her mother, even though they lived together.
"I walked in on her one time and saw she couldn't get her jeans up. One side effect of Depo is she gains weight. She said she felt fat and ugly," Hedrick said. "I said, 'Constance, are you pregnant?' And she said, 'No. I'm not pregnant." It was like her body and mind went in different directions." Baugh gained only ten pounds. She had no prenatal care.
Of course, Baugh did not have the number one sign of pregnancy, a cessation of normal menstrual periods. Her periods had been erratic since she went on Depo-Provera. She generally had no periods, but in July of 2000, a month before she was told she was pregnant, she had significant bleeding, so significant that a cop from the carnival had to give her a ride home.
In late January of 2001, Baugh complained to Hedrick that she'd started a period and was bleeding heavily. Hedrick gave her some pads and Motrin. Baugh went to bed. Hedrick let Baugh's two-year-old daughter, Angel, sleep in her bedroom.
"The next morning, I found Constance on her knees in a fetal position," Hedrick said. "She said she was fine and I helped her to bed."
But Baugh was bleeding badly. Hedrick's husband called 911. Hedrick cleared Angel's toys from the floor of Baugh's room, tossing them in the closet so the ambulance crew could get in and take care of Baugh.
At the hospital, while Baugh was taken to intensive care to be treated for internal hemorrhaging, officials called Hedrick into a private room. "I thought they were calling me into the room to tell me my daughter had died. They said she'd given birth to a baby and where was the baby? I said they were liars."
By the time Hedrick got back to her home, police had already found the body of Baugh's newborn child wrapped in a blanket in the closet. The child lay among the toys Hedrick had tossed there.
"They're saying she had the baby in the bedroom," Hedrick said, based on what she heard at the baby's death inquest. "They're saying the baby felt cold, so Constance wrapped up the baby in a blanket and then passed out. For that they're saying she suffocated the baby."
Hedrick believes Baugh was depressed and perhaps even psychotic when she gave birth. She blames the Depo-Provera. "From what I've read, any woman with a mental illness history in the family should not be on Depo," Hedrick said.
Hedrick says Baugh has a history of depression in her family. She said Hedrick became so depressed while she was on Depo-Provera that she tried to overdose on Tylenol. Hedrick says Baugh told doctors she was depressed.
"I've got pictures. I've got video tape," Hedrick says, "but there are times I can't even watch them they make me feel so emotional. To see her how she was before she got on that Depo is heartbreaking."
A Long Fight
Cindy Pearson, executive director of the National Women's Health Network, worked against Food and Drug Administration approval of Depo-Provera in the mid-1990s and continues to be concerned about potentially adverse effects on women.
She points out that hormonal contraceptives have side effects that can vary tremendously from woman to woman.
"For every woman who has a problem there are many women who have nothing like that and can be happy on the same product," Pearson said. "The problem with Depo is that once you're on it there's no way out except waiting it out." And the wait may be longer than three months.
"People who love the drug are not lying when they say it has minor side effects but they're only telling part of the story. We've tried to bring the other part of the story to women's awareness, so they know they face a range of side effects and not just the rosy picture in the brochure," she said.
Depo-Provera has what Pearson calls a "quirky history" of approval. The FDA rejected it in the 1970s because tests on beagles and monkeys showed increased rates of cancer. In addition, no long-term study on women had been done.
But in the 1990s, the World Health Organization financed long-term studies in women that showed no clear risk of cancer. There was a hint, Pearson says, but only a hint, that it may be related to an increased risk of breast cancer in young women.
In addition, the FDA changed its rules to accept testing with rats and mice instead of dogs and monkeys. Depo-Provera passed the rat and mice tests.
The side effects of Depo-Provera drew little notice, said Pearson. "Why below the radar?" she asked rhetorically. "People who are trying to provide contraceptives to women and men who want to postpone children think on the bottom line about postponing pregnancy, and they don't think what's it like living with it."
That angers her. "What gets me mad is mention the word 'condoms' and every man has something to say about what an inconvenient thing it is to use condoms. But here we've got a method that can really be a drag for women all day long. If they rated men's and women's experience of birth control we'd be describing Depo with the same disagreement as men's condoms."
Damage to Relationships
As many people testify, Depo-Provera can end up being as big a drag for men as for women, especially if the side effects damage the relationship. Pearson believes the evidence supports blaming the drug.
"Acne. That's a slam-dunk. It's in all the literature for birth control clinicians," Pearson said. "Lack of lubrication is absolutely hormonally related." In addition, weight gain and irregular menstrual bleeding, which are strongly linked to Depo-Provera, are also know to be sexual turnoffs for some people. Then there are the hormones.
"There's not an absolute link that if you turn off women's hormones you turn off women's interest in sex, but it is not unrelated," she said. "Depo-Provera turns off the ovaries with large does of progestin [synthetic progesterone]. Theoretically, it makes sense that it turns off normal hormone levels. There's a logical theory there about why Depo-Provera could cause loss of libido in some women."
Local Planet December 14, 2001
Dr. John Lee hates Depo-Provera. He believes it's totally useless and never needs to be used.
I couldn't agree more. I lectured with Dr. Lee in Chicago a few years ago and I have great respect and admiration for what he has done for bringing natural hormones, particularly progesterone, to our attention.
His book What Your Doctor May Not Tell You About Premenopause is must reading on this topic.
The key to remember here is that Depo Provera is NOT progesterone. It is a synthetic progesterone and is more accurately called a progestin.
This hormone is so dangerous that if you are taking it (or most all birth control pills) during the first stages of pregnancy there is a high likelihood that an abortion will occur.
This is because the progestin actually binds to the progesterone receptor stronger than progesterone does and when it binds it actually blocks the real progesterone from providing the beneficial effects on the placenta and fetus. As a result the baby dies from progesterone starvation.
The amazing fact to also recognize is that progesterone deficiency is actually the cause of over 90% of first trimester spontaneous abortions.
I also can't think of even one clinical situation where birth controls are ever necessary.
Generally it is wise to avoid absolute statements, but it seems that there is never any reason to take Depo-Provera or birth control pills as there are far safer and more natural options that address the underlying cause of the problem and are far less toxic.