From the desk : of Dr. Randy Short
History of Depo-Provera:
*1967-1978: The largest test on humans of Depo-Provera begins and is conducted for eleven years through the Grady Clinic in Atlanta, GA on 14,000 women. 50% of the subjects in this experiment were Black, low-income, and rural women. The trials were conducted on many of these women without their knowledge or consent, violating FDA regulations. They were also not told that there were side effects associated with Depo.
Several women got cancer and/or died during the trials, but these cases were not reported to the FDA as was required. The director of the study, Robert Hatcher, did not send one legally required annual report during the entire study. Women with medically contraindicated conditions, such as cancer, were still given the shot. Record keeping on the clients was sloppy – over 13,000 women were lost to follow-up.
*1967: The FDA withholds approval of Depo-Provera.
*1968: In beagle and rhesus monkey tests, Depo was linked to increased risk for breast and uterine cancer. Dr. Solomon Sobel of the FDA testified that there are no contraceptives that are carcinogenic in beagles which have reached the United States market.
*1978: The FDA again denies approval of Depo for contraception because: 1) dog studies confirmed an elevated rate of breast cancer; 2) increased risk of birth defects in human fetuses exposed to the drug; and 3) no pressing need shown for use of the drug as a contraceptive.
*1980s: Phoenix and Oklahoma City Indian Health Services use Depo-Provera on Native women with disabilities, despite the fact that it wasn’t approved by the FDA. Reason given was for “hygienic purposes” – or to stop the periods of patients with developmental disabilities. Raymond Jannett of Phoenix IHS says that “Depo-Provera turns [Native women patients] back into their sweet, poor handicapped selves.”
*1983: The FDA again denies approval of Depo.
*1987: The FDA changed its regulations and began to require cancer testing in rats and mice instead of dogs and monkeys; Depo did not cause cancer in these animals.
*1992: The FDA approves Depo-Provera, despite the objections of the National Women’s Health Network, the Naitonal Black Women’s Health Project, and the Women’s Health Education Project.
*2002 (in India): Because of pressures from Indian women’s organizations, on January 3, 2002, the Indian Government dropped its plan for introducing Depo-Provera (and Norplant, another provider-controlled contraceptive) for distribution through the government health services system.
*2004: Pfizer, Inc., current owner of Depo-Provera, submits data to the FDA indicating that women using Depo experience significant loss of bone mineral density (BMD). The FDA announces a label change for Depo including a black box warning highlighting concerns about loss of bone density, detailed information about studies in which bone loss was observed among Depo users, and a warning that Depo should not be used for more than two years unless other birth control methods are inadequate and that the BMD of Depo-Provera users should be evaluated if use is continued long-term.
*2004: A study funded by the U.S. Agency for International Development (USAID) and the National Institute of Child Health and Human Development finds that women using Depo have a three-fold increased risk of acquiring chlamydia and gonorrhea. From 1994-2000, USAID provided 41,967,200 units of Depo-Provera into the developing world, at a cost of over $40 million. USAID sends more units of Depo-Provera to Africa, to countries such as Mozambique, Tanzania and Nigeria, than to any other part of the world.
Who Currently Uses Depo-Provera?
In a recent study of Depo users in the U.S., 33 percent were under the age of 19, 84 percent were Black women, and 74 percent were low income.
Critical Side Effects:
Depo-Provera has the following critical side effects on its users:
Breast Cancer: According to three separate studies, breast cancer occurs two to four times more often among young women who use Depo-Provera.
Osteoporosis: Depo-Provera is now believed to cause loss of bone mass among women. Osteoporosis is a debilitating condition that becomes more life-threatening as women grow older.
Cervical Cancer: Some studies indicate that Depo-Provera increases the risk of cervical cancer.
Excessive Bleeding: Depo-Provera can cause heavy and prolonged menstrual bleeding.
Weight Change: On average, Depo users gain 12-16 pounds over four to five years, but some women have gained up to 40 pounds.
Difficulty Getting Pregnant: Some women who stop using Depo-Provera don’t get their period again for as long as two years, preventing pregnancy for much longer than intended.
HIV, Chlamydia, & Gonorrhea: Recent studies have shown that women using Depo have an increased risk of contracting HIV, chlamydia, and gonorrhea
Other Side Effects: Severe Depression, Loss of Sex Drive, Fatigue, Dizziness, Headaches, Nervousness, Abdominal Pain, Hair Loss, Facial Hair Growth
Furthermore, the users of Depo-Provera cannot remove the provider-administered injection under any circumstances. Once you’ve gotten the shot, there is no antidote to reverse its effects. Women can suffer from side effects long after they have stopped using the drug.
Depo-Provera, Coercion, & Criminalization:
The “choice” of using Depo is sometimes made under pressure. For instance, young black women in South Carolina and Chicago, Illinois reported that they were pressured into accepting either Norplant or Depo-Provera immediately after giving birth. In several states, judges have given women convicted of child abuse or drug use during a pregnancy the option of taking Depo or Norplant in lieu of serving jail time. Women on welfare were the targets of approximately 20 bills, amendments, and welfare proposals offering financial incentives to women to use long-term contraception such as Depo or Norplant.
Increased Risk of Contracting HIV & STDs
Depo-Provera use is associated with decreased condom use, which raises a women’s susceptibility to sexually transmitted infections (STIs) and HIV infection. Some studies also indicate that Depo-Provera may even be an independent risk factor in contracting HIV and other STIs. In September 2004, The Journal of the American Sexually Transmitted Disease Association reported that Depo also increases the risk of acquiring the chlamydia and gonorrhea.