a chemotherapy agent for the treatment of certain types of uterine cancer. However, itonly gained approval for use as a contraceptive in the U.S. in 1992. By 1996, Depo-Provera had cornered 7% of the contraceptive market and garnered the Upjohn Company$160 million in sales revenues.
Depo-Provera is now approved in more than 70 countries including the U.S., France,Germany, Sweden, and the United Kingdom. A once-monthly version of Depo-Provera,called Cyclofem (also known as Cyclo-Provera) has undergone clinical trials in Chile,Indonesia, Jamaica, Mexico, Thailand, and Tunisia. Medical Advertising News predictsstrong market potential in Latin American, China and Eastern Europe.
Who Uses Depo-Provera?: The Image and the Reality
In the United States, despite extensive print and groundbreaking television advertisingcampaigns targeted toward middle-class women, Depo-Provera is more often utilized by poor or working class women and women receiving primary healthcare from federal andmany state-funded health clinics. This is buoyed by an agreement that Upjohn Companymade in 1994 to supply Depo-Provera on a "buy one, get one free" basis to Title X-funded agencies and clinics.
Across the U.S., Depo-Provera has been further subsidized by state and local governments (Houston, Texas recently purchased $1.3 million worth of Depo-Provera for dispensation at city health clinics serving the poorer strata of Houston).
In less than a decade, Depo-Provera has had a significant impact. Depo-Provera use has been credited with a dramatic reduction in teen pregnancies and is the contraceptivechoice for approximately 8% of white teens and 19% of black teens. The increased mediafocus on teen pregnancy reduction coupled with the lack of similar focus on the potentially adverse effects of Depo-Provera use are likely to ensure that the numbers of teens on Depo-Provera will continue to rise. A recent study of Massachusetts family planning clinics found that Depo-Provera use has risen 77% over the past three yearsamong women ages 20 and younger.
A 1997 issue of Drug Topics notes that Depo-Provera was among the top ten drugs for which the FDA received reports of adverse experiences.
Teenagers in particular need to be concerned with the potential (and considerable) side effects of Depo-Provera.
Important Side Effect Considerations For Teen Users
Body Image: At the 1999 Master of Pediatrics Conference in Miami, Paul Jenkins notedsome teen Depo-Provera related weight gains upwards of thirteen pounds in a year andwarned pediatric practitioners to "expect significant weight gain in teenagers using Depo-Provera contraception, especially if they are already heavyset".
For teens excess weightgain can contribute markedly to depression, poor body image, and eating disorders -serious problems to which young women are already very vulnerable. Other side effectsof Depo-Provera that can negatively impact body image include hair loss, delayed hair growth, acne, and rashes.Bone Loss: Over the long term Depo-Provera results in decreases in bone mineral densitythat can inhibit bone growth and substantially increase the risk for fractures and futureosteoporosis. High rates of lactose intolerance and/or milk allergies among women of color mean that this calcium loss can have a much greater impact.