Explain how Depo‑Provera injection prevents ovulation, list two major side effects, and recommend an alternative contraceptive method suitable for a 28‑year‑old woman with well‑controlled hypertension.
Answer
Depo‑Provera suppresses the LH surge, preventing ovulation; major side effects are menstrual irregularities and decreased bone mineral density; a suitable alternative is low‑dose combined oral contraceptive pills (ethinyl estradiol + progestin).
Step-by-step solution
- Describe mechanism: Depo‑Provera contains depot medroxyprogesterone acetate; it raises progesterone levels which suppresses the hypothalamic–pituitary–gonadal axis, blunting the LH surge needed for ovulation.
- List major side effects: 1) menstrual irregularities or amenorrhoea; 2) loss of bone mineral density due to prolonged low estrogen exposure.
- Recommend alternative: a low‑dose combined oral contraceptive pill (e.g., 30 µg ethinyl estradiol + 150 µg levonorgestrel) provides effective contraception, maintains estrogen for bone protection, and is well tolerated by women with controlled hypertension.
Common mistake: Forgetting that Depo‑Provera acts by hormonal suppression of the LH surge
Concept tested: Mechanism of Depo‑Provera and alternatives
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