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Depo Provera May Raise STD Risks

Injectable Contraceptive Linked to Higher Chlamydia and Gonorrhea Risk
WebMD Health News

Aug. 23, 2004 -- Women who use the injectable contraceptive Depo Provera may face a higher risk of some sexually transmitted diseases, according to a new study.

Researchers found women who used Depo Provera were more than three times as likely to become infected with chlamydia or gonorrhea over the course of a year than women who used birth control pills or nonhormonal contraceptives.

"These findings underscore the need to counsel all sexually active women who use [Depo Provera] and who are not in a mutually monogamous relationship to use condoms consistently and correctly," says researcher Charles Morrison, PhD, of Family Health International in Research Triangle Park, N.C., in a news release. "For sexually active women not in a mutually monogamous relationship, limiting the number of partners may also help to reduce the risk."

Researchers say an estimated 20-30 million women use Depo Provera, and its use is growing quickly in many developing countries with a high prevalence of sexually transmitted infections. The contraceptive consists of a long-acting hormone that is injected into either the arm or buttocks four times a year.

Like all hormonal contraceptives, Depo Provera does not provide protection against sexually transmitted diseases (STDs). Chlamydia and gonorrhea are among the most common STDs caused by bacteria and about 150 million new cases of chlamydia and gonorrhea are reported worldwide each year. They are responsible for a number of conditions including pelvic inflammatory disease and infertility.

No Greater Risk With Birth Control Pills

In the study, which appears in the September issue of Sexually Transmitted Diseases, researchers compared the effect of oral contraceptives and Depo Provera on rates of chlamydia and gonorrhea in a group of 819 women. Most of the women were single, 43% were black, and the average age was 22.

Over the course of a year, the study showed that 45 women developed chlamydia or gonorrhea.

Women who used Depo Provera were 3.5 times more likely to have an STD compared with women using a nonhormonal contraceptive.

Researchers found no significant increase in STD risk among women who used birth control pills.

Researchers say the study wasn't able to determine how use of Depo Provera might increase the risk of infection with a STD. But they say it's possible that the injectable contraceptive may decrease estrogen levels and lead to an increased susceptibility to vaginal and cervical infections.

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