Describe how Depo‑Provera injection prevents ovulation, list two major side effects, and recommend an alternative contraceptive method for a 35‑year‑old woman with well‑controlled hypertension.
Answer
Depo‑Provera suppresses LH surge preventing ovulation; major side effects are menstrual irregularities and decreased bone mineral density; for a woman with hypertension, a copper IUD is recommended
Step-by-step solution
- Depo‑Provera releases high dose progesterone.
- High progesterone suppresses the pituitary release of LH surge.
- Without LH surge, follicular maturation and ovulation are blocked.
- First major side effect: menstrual irregularities such as amenorrhoea or prolonged bleeding.
- Second major side effect: decreased bone mineral density due to hypoestrogenic state.
- Combined oral contraceptives are contraindicated in hypertension because estrogen can raise blood pressure.
- A copper IUD is a non‑hormonal option suitable for women with hypertension.
- Therefore recommend a copper IUD for this patient.
Common mistake: Assuming Depo‑Provera acts like estrogen; overlooking contraindications of estrogen in hypertension
Concept tested: Hormonal contraceptive mechanisms and side effects
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