How I descended into the dreaded abyss of Depo-Provera and lived to tell the tale: a cautionary story

January 31, 2011 § 10 Comments

I would like you to imagine the rest of this post spoken with the voice of this man:

 

Argh

 

I was talking to the fabulous Jamie the other day about the horrors of Depo-Provera and he said something that really surprised me: that plenty of trans guys saw Depo-Provera as some kind of wonder drug, given the whole ‘goodbye menstruation’ factor. It wasn’t something that had ever occurred to me, given my own experiences. So, what follows is a personal account and, yes, a warning. No one experience can speak for all, and I’m sure that for some people Depo can be a great help – but I wish I’d heard a whole bunch of different opinions before I let my doctor talk me into it.

Right, so, if you know me you know that I can’t take T. You also know that I’m rather fond of the gentlemen, be they trans or cis. Well, as fond as someone as terminally pessimistic about human nature as I am ever can be. Which is to say, though I hate to even admit it, occasionally I have to think about birth control. Don’t make me say it again.

Along with that, though I’m not actually terribly fussed about the supposed ‘female’ nature of menstruation, I do get debilitating pain, which my doctors have been trying to manage since puberty.

So when I went to see my doctor about contraceptive options they were very to keen start me on Depo-Provera. They know that I’m trans. I made it very clear that there were side effects I wasn’t prepared to deal with (breast growth, anyone?). And they assured me that Depo has barely any side effects. I don’t know if they genuinely believed this, or whether the fact that I sleep with men automatically made me a woman in their eyes.

Anyway – would you like the list?

Well, the worst, and the most  relevant for any trans guys considering it: the bodily feminization. I was pre-surgery at this point, but small enough that I didn’t necessarily need to bind (AAA cup) – no hips, no thighs, thank you very much. In six months I gained a stone, and suddenly I had these hips and thighs and tummy and waist, and while an A cup doesn’t sound like much it was fucking agony. My face filled out. My muscles atrophied. I kept food diary after food diary – it wasn’t the calories in. I went to see a dietician – my metabolism had slowed and my Vitamin D had dropped enough to concern her. I was permanently hungry, and swollen and bloated.

It was a year after my last injection before my body came round. And, even now, it doesn’t feel quite the same as it used to.

Oh, and the ‘no more menstruation’? I would bleed randomly, with no warning, for ridiculously long periods (no pun) of time. Once for six weeks running – then a five day break – then another four weeks. And once so badly that they were worried I had, in fact, become pregnant and was suffering an early miscarriage (thankfully not, but it was a frightening day).

Neither one of these factors was ever discussed. And if they had been I would never have taken the drug. I was actually on it for nearly a year – I kept being told that the side effects would ease. They did not.

Everyone should have the right to choose their own treatment. But, please – do plenty of research. Maybe it might be worth it for you – but please consider just how hight the cost might turn out to be.

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§ 10 Responses to How I descended into the dreaded abyss of Depo-Provera and lived to tell the tale: a cautionary story

  • Cat Ashton says:

    I am utterly with you on this. I may not be trans, but I too had all of these hellish side effects from depo.

    My gp put me onto it for 16 months when I was 16 when it was first on the market. I went from being a happy size 12 to a 16, had major bleeding and triggered a major bout of depression.

    Now over 5 years since I stopped taking it I can’t loose the weight and am still dealing with the mental breakdown that it triggered.

  • cnlester says:

    Thanks for sharing – that’s absolutely awful. All the best of good luck x

  • Moof says:

    So, if one may ask, have you found a solution to the birth control problem? Depo seems the wrong answer for you, but have you managed to find something to substitute it, or do you rely on barrier methods?

    • cnlester says:

      I thought I would give old-fashioned celibacy and Freudian sublimation a try.

      Seriously? Barrier methods seem the way forward – and trying to find a sexual health worker who understands what my needs are if I need to find a more long-term solution.

  • Milo says:

    Hey, I read this on QYN and replied on there as Jamie posted it, but thought I would on here too. I work in sexual health and wouldn’t hesitate to recommend Depo Provera to any young person I work with – provided it’s right for them and they understand the risks involved.

    With any medication, particularly medication that messes around with hormones and menstruation, there are going to be side effects like the ones you experienced and it’s important to remember that this drug isn’t made for trans men or similar to stop periods, it’s targeted at women, to stop them getting pregnant. Most women, I’d hazard a guess, would prefer to put up with irregular bleeding and most of the other side effects in order to prevent that.

    In the possible side effects it also lists “irregular periods, amenorrhoea (very light or no periods)” – which is generally more common than the bleeding you experienced, but it does happen, particularly if people miss their injections (which is the case with most other people I know who have experienced that level of bleeding)

    It sounds like your doctor was very much at fault by not giving you much information – there’s 21 lines of possible side effects in the leaflet. Have you made a complaint at all?

    • cnlester says:

      Hi Milo,

      I’m afraid I never missed an injection (I was pretty paranoid about doing it right).

      My doctor was definitely at fault (and this was the last in a string of things she was wrong about that got me to change doctors – I didn’t feel able to cope with making a complaint) – no leaflet, no nothing. Just a refusal to discuss non-hormonal methods of contraception and a blind assurance that Depo was a wonder drug – particularly because she asserted that nearly everyone on it found that it stopped their periods.

      Having done more research on it since then, I really was shocked that there was the idea among some trans guys that it was a good option in terms of stopping menstruation. If your main concern is not to get pregnant then it certainly does its job on that front – but my cis female friends who’ve been on it have had similar experiences with side effects, and clueless/lazy GPs pushing a drug without considering the whole picture.

      Sigh. I guess I would just advise people to do as much research as they can independently, and to try to find a medical health professional that they trust to discuss their options with.

  • ro says:

    I know I’m late to the party but…. never recommend depo to young people!!!!!! Not unless they have no other options (there are always other options). It screws up bone density. Not drastically, but enough to be significantly bad. In the US it has a “black box warning” – the UK is just lazy about these things.

    This post interests me because I’m on the oral tablet form of depo. It’s not a contraceptive, technically, but I haven’t had a period for over 2 years so it’s got to be doing that job alongside others. I’m taking it for endometriosis – CN please look this up. It could be a possible explanation for your debilitating pain. I was told recently that periods can cause discomfort, but should never cause distress. If so, something may be wrong.

    Anyway, depo is 150mg injected every 12 weeks. I take 20-30mg every day. Maybe the metabolism is different between intramuscular and oral, but I bet a take a whopping amount more than depo. So your post got me thinking.
    Luckily I’ve managed to lose much of the weight I put on (though maybe some of that was due to being endo-ill and not exercising) and the stretch marks have faded.
    I’m paranoid about the bone loss though. Anyone who needs to be on depo – do weight bearing exercise, eat shitloads of fruit and veg, and get calcium.

    CN, if you have an ongoing suitable contraception mystery, have you considered Mirena (coil) or Implanon/Nexplanon? Mirena can cause worse bleeding for about 6 months but can often result in no bleeding for the remaining 5 years that it’s in. Implanon I know less about…

    Good luck with it.

  • Kat says:

    Copper IUD is the way to go.. It does hurt to get it in, but the payoff is worth it. Stay away from Mirena. It is progesterone.

  • Cairtheand says:

    I know this is ages after the fact, but I want to thank you for writing this (since I was considering it, but only for a short while). People should never blindly trust their doc, is what I´ve learned too. Most cases, they are just making an educated guess (our own educated guess often being just as good…).

  • Andrea Krahn says:

    Depo made me crazier than a shit-house rat. Almost as bad as oral contraceptives (which make me curl up in the fetal position and think only of which knot would be best to use if I hung myself from a doorknob — and which scarf would best suit the occasion). After the age of 27 I could no longer tolerate hormones of any kind in my body. I had a steroid epidural on my C4-5 and had about a dozen side effects (including depression and insomnia) for months after.

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