Describe how Depo‑Provera injection prevents ovulation, mention two major side effects, and recommend an alternative contraceptive method suitable for a 30‑year‑old woman with well‑controlled hypertension.
Answer
Depo‑Provera, a progestogen injection, suppresses the pituitary release of gonadotropin‑releasing hormone, preventing the LH surge and thus ovulation. Two major side effects are decreased bone mineral density and irregular menstrual bleeding. A suitable alternative for a woman with hypertension is the copper intrauterine device (IUD) as it does not alter blood pressure.
Step-by-step solution
- Depo‑Provera is a depot progestogen that acts centrally to inhibit gonadotropin‑releasing hormone (GnRH) from the hypothalamus, thereby suppressing the pituitary release of LH and FSH; without the LH surge, ovulation does not occur.
- List major side effects: (i) Reduction in bone mineral density due to prolonged progesterone exposure, (ii) Irregular or prolonged bleeding patterns.
- Recommend alternative: Choose a copper IUD, which is non‑hormonal, has no effect on blood pressure, and offers long‑term contraception.
Common mistake: Forgetting that Depo‑Provera suppresses the LH surge
Concept tested: Mechanism and side‑effects of progestogen contraception
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