The Dangers of Depo is a collaboration between Dr. Poppy Daniels, wholistic gynecologist specializing in bio-identical hormone therapy and Traci Johnstone, former Depo user and sufferer turned advocate. Together they expose the effects from depo, discuss the global and political ethics of depo use in third world countries, and explore ways for depo sufferers to heal and regain health after coming off this powerful drug. One thing is certain, after reading their book, I don’t want anyone going near that needle.
Daniels goes into depth talking about how depo works and what makes it so potent. The shot contains Medroxyprogesterone acetate (MPA) which is a synthetic form of progesterone, called a progestin. The primary functions of how it works as contraception is similar to other pharmaceutical options. It suppresses hormonal production to low levels (like lower than menopause low), dries up cervical fluid, prevents most ovulation attempts, and keeps the lining of the uterus thin. All of these mechanisms are meant to either prevent an egg from fertilization and/or a fertilized egg from implantation. But Depo’s performance record seems less than ideal when you look at the risks vs benefits. Unlike other hormonal contraception, you can’t stop the hormones from entering your bloodstream once the shot has been administered. And furthermore, the withdrawal from the drug can often be worse than the actual use of it. After the intense suppression of hormonal production, the body exaggeratedly begins producing high levels of estrogen. But because ovulation is so unlikely to occur, there is no progesterone being created to balance out the estrogen. This causes a whole other host of side effects.
Speaking of side effects, I can’t even list all of them, either while on Depo or after coming off the shot, because they literally take up pages and pages in Daniels’ and Johnstone’s book. The most controversial side effect is a lower immune system (which poses an issue particularly in populations with already compromised immunity, such as high AIDS areas), loss of bone density, and certain cancers, particularly cervical and breast cancer. Anemia, digestive issues, insomnia, depression, heartburn, risk of stroke, infertility, hypertension are only a handful of other issues women experience.
Johnstone, who had a particularly rough go after only a short time on Depo discusses her experience in great depth in DOD. In short, depo caused acute adrenal suppression, which wreaked havoc on her hormones, it destroyed her fertility, she lost her uterus due to a medical hysterectomy, her teeth and bones experienced rapid decay because of lost bone mass, and lastly, the ongoing infections she experienced due to a failed immune system snowballed into critical condition, which had she been properly treated from the get go, might not have been so detrimental. She lost jobs, friends, and her health. Reading her chapters left my head spinning and my body aching. It’s no wonder she has made campaigning against Depo her vocation.
According to DOD, Depo is currently one of the least popular pharmaceutical options for hormonal contraception in America, less than 5% of women use it. Yet it is still being pushed hard overseas as a popular, safe, and effective way to manage (re: inhibit) fertility. The most controversial aspect of this is the prioritization of preventing pregnancy over AIDS prevention and care. Not only does depo not prevent AIDS from being contracted, such as condoms, but it can actually increase risk of AIDS contraction, and rapidly progress the disease. Daniels commented on the new Sayana Press - a DIY version of Depo (not available in the US or Canada) that widens the gap even further between impoverished communities and health care providers.
There was a wonderful portion of DOD dedicated to healing from Depo. I appreciated this because it didn’t leave those who had been harmed by Depo with solely regret and guilt. It gave people an action that they could do to 1) regain health and 2) spread awareness about consequences of Depo that might have been overlooked when you decided to start.
I certainly learned a lot throughout DOD. I am now armed with even more information on how to aid my future clients who are getting off of this powerful contraception. The book did, however, leave me with a few important questions and concerns.
- Is Depo particularly more harmful than other hormonal contraception? What specifically makes Depo drastically different, it at all, from other hormonal options? Isn’t bone loss and loss of nutrient absorption the case with any steroid?
- Fertility Awareness Methods were addressed but alternatives for family planning could have been mentioned a little more.
- This wouldn’t need to be addressed in the book necessarily but I did wonder what call to action could be done to address the use of Depo in third world countries where comprehensive consent may not be currently happening. What efforts could be joined in? Where can we turn if we want to boost fertility literacy in impoverished communities?
- I found the women’s stories section to be so overwhelmingly vast, I eventually skipped over some and skimmed others. Useful perhaps in a presentation, that section left me a little defeated. I could have done without it, or at least in the format of listing them page after page after page.
These were just a few of my takeaways and a basic summary of what was covered in DOD. Read it for yourself to delve deeper into the complexities of Depo! Ultimately, I highly recommend DOD. It’s an important piece in the conversation of how we can improve consent in the doctor’s office, encourage fertility literacy and empowerment for women everywhere, and reassess our family planning risks and benefits.
'Til next time,