WOMENS-HEALTH Messages for January, 1998: Re: Spotting after Depo Provera

Re: Spotting after Depo Provera

From: D. Ashley Hill, M.D. (anonymous@obgyn.net)
Sun, 4 Jan 1998 17:21:37 -0600 (CST)

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In reply to: Darcy: "Spotting after Depo Provera"

At Fri, 2 Jan 1998, Darcy wrote: >
>I stopped taking the Depo Provera shot in order to conceive. I realize
>that it may take quite a while. I was wondering if the spotting that I
>am having will continue until I start ovulating again.

Darcy-

Spotting after depo-provera is extremely common, and is almost always due to the lining of the uterus, called the endometrium, being too thin. This is a side-effect of the medication that is beneficial in reducing one's chance of uterine cancer and pregnancy, but not so hot when it comes to spotting.

Although I have never seen any written information on uterine lining size and conception, my gut feeling is that it is detrimental to implantation.

It's usually easy to fix. I prescribe my patients conjugated estrogen (i.e. premarin) 1.25 mg by mouth each day for 10-14 days to thicken the lining a little. One course of treatment usually does it. If not, a repeat course of treatment does the trick. In the few patients who don't respond to this, I usually do a saline-infusion vaginal ultrasound to rule out benign endometrial polyps as the cause of spotting. However, it's unusual to get this far, as the estrogen almost always works.

Good luck,

-- Ashley Hill David Ashley Hill, M.D. Associate Director Department of Obstetrics and Gynecology Florida Hospital Family Practice Residency Orlando, FL http://www.gate.net/~dahmd

I apologize, but I am unable to answer personal e-mail due to time constraints.

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In reply to: Darcy: "Spotting after Depo Provera"

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