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
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.
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
"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
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
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,"
"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
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,
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.
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
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
"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
"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
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 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
She points out that hormonal contraceptives
have side effects that can vary tremendously from woman to
"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
"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."
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
December 14, 2001