As a women’s health advocate, educator, and activist, I have followed the evolution of birth control over the last 35 years. I have witnessed a particularly troubling change as women have gone from being “in control” of early birth control methods like the pill, condom, and diaphragm, to newer methods (particularly in the class of long-acting reversible contraceptives, or LARCs) actually being used to control women. As I will explain in this article, Depo-Provera, in particular, is a unique example of this phenomenon.   

The evolution of birth control: From control over birth, to controlling women 

With the advent of the “Pill” in the 1960s, women gained the ability to control their fertility with synthetic hormones to prevent pregnancy. In those early days of modern contraception, there was the pill (controversial even then due to high levels of estrogen), diaphragms, and condoms. While people used these initial methods with varying degrees of efficacy, in terms of their ability to stop or start their use, women and men were in control of these methods.   

But then the options changed. Out of convenience and a marketing message that convinced women that menstruating monthly was not necessary, birth control pills with longer acting synthetic hormones were introduced. These could delay menstruation for months—and even years—at a time. LARCs (long-acting reversible contraceptives), such as the IUD, were also introduced to the market. Along with the IUD, other LARCs such as Depo-Provera (an injection of synthetic hormones), Norplant/Implanon (a silicon rod filled with hormones implanted into the arm), and the NuvaRing (a hormone-filled ring placed on the outside of the cervix) also found their way to the market.  

These advancements were heralded as landmark achievements in the movement for women’s health freedom and their right to choose. But suddenly, with the advent of LARCs that required a doctor’s removal to become ineffective, or (in the case of Depo-Provera) a much longer time to “wear off,” women went from being “in control” of their birth control, to actually having very little control at all over these new contraceptive devices and methods.    

What is Depo-Provera?   

In 1959, medroxyprogesterone acetate (MPA) was given FDA approval for the treatment of menstrual disorders. Soon, Depot Medroxyprogesterone Acetate, [DMPA] better known as Depo-Provera, or the Depo shot, would be approved and marketed as a contraceptive.  

An injectable contraceptive containing progestin (a synthetic form of progesterone), Depo is administered by injection in either the arm or buttock once every three months. Perhaps unbeknownst to many women who use Depo for birth control, a woman may not be able to conceive for up to a year or more after stopping the injections.   

Depo and its possible effects on fertility 

At one point in time, when I was blogging about hormonal contraception, I was using Google Alerts to keep up-to-date on news stories and advancements in birth control. One day, an alert appeared in my inbox on how incarcerated men were being injected with Depo-Provera to inhibit their sexual drives. At first, I was surprised, because I had not created a Google alert for male sterilization, but I read the article and realized the author was referring to a method of birth control commonly prescribed to women.  

My first response was naturally: What if Depo-Provera also creates chemically-induced sterilization when injected into women? Although I was reassured in the article that Depo had a different mechanism of action in women, I was not convinced. Since then, I’ve researched and read women’s stories in various birth control and Depo groups on Facebook, and have been horrified at what I’ve found.  

Although little research has been done on the long-term fertility effects of Depo, many women over the decades have noted the drug’s pitfalls. Authors Traci Johnstone and Poppy Daniels, MD, have even written an entire book on the subject: The Dangers of Depo, On the topic of Depo’s long-lasting fertility effects, the authors have this to say: “Depo is an anti-fertility drug. That’s different than a birth control drug. That means it can inhibit fertility long after it’s stopped.”   

The cultural context of Depo and sterilization 

In the early 1900’s, forced sterilization was heralded by eugenicists under the guise of “Better Baby Contents” at state fairs, and perpetrated against people of color and other indigenous races, as well as men and women in mental institutions. By the early 1970’s, cultural mores and books concerned about uncontrolled population growth fueled the conversation of starvation, and the need for population control. Proposals to stem population growth included sterilizations, tax increases on families with more children, child quotas, adding a sterilant to drinking water, and governmental oversight of fertility growth in the U.S.   

Between 1967–1980, Grady Memorial Hospital in Atlanta, Georgia tested Depo-Provera on more than 7,000 poor black women. Wendy Kline, author of Building a Better Race: Gender, Sexuality, and Eugenics from the Turn of the Century to the Baby Boom, cites that during her research she found a box containing hundreds of files detailing the side effects of Depo and how women had not been informed about them.   

These are just a few of the examples of how Depo-Provera has historically been used to control the fertility of “undesirable” populations within the United States. But across the world, women are still being forcibly sterilized through various methods, whether via chemicals, devices, or surgeries. Many more are likely accepting birth control options like Depo-Provera without informed consent, and unaware of the long-term impact it may have upon their fertility.   

Depo damages women in the developing and developed worlds

At the London Summit of Family Planning in 2012, Melinda Gates outlined a plant to “empower” women and girls by raising millions of dollars to increase contraceptive distribution in the developing world. The result of these and other Western-led pushes to increase contraceptive use, particularly in the developing world, is that Depo has become the contraceptive drug of choice for millions of women all over the world. 

That Depo has become so popular in the developing world is particularly concerning, especially given its known ability to increase a woman’s risk of contracting HIV (the virus that causes AIDs), and its severely detrimental effects on bone mineral density. With HIV, AIDS, and osteoporosis already posing large disease burdens on women within developing countries, we should be more concerned that Western contraceptive campaigns could be making these burdens even worse. 

There is reason to believe that in the United States and the rest of the developed world, women aren’t much better informed about the dangers of Depo-Provera—and it’s negatively affecting them, too. As I mentioned earlier in this article, I spend a great deal of time reaching out to women in various social media groups who have suffered side effects from Depo and other contraceptives—side effects they knew nothing about at the time they were prescribed these drugs and devices. Many feel completely blindsided by the slow return to fertility and hormone balance after being on Depo, and many have been gaslighted by their physicians when they raise these issues with them. 

The dangers of Depo are real. And they are hardly warranted, given the the plethora of effective family planning options available to women today. That is why Natural Womanhood, a non-profit organization dedicated to truth in women’s health, is calling on the FDA to remove this product from the market. If you believe that Depo has got to go, and that women deserve better information when it comes to hormonal contraception, we encourage you to sign this petition today.

Leslie Carol Botha is an author, Women’s Health Advocate, and Media Manager for IUDAlert.com. She has been involved in holistic hormonal health for over 30 years.  Botha is a graduate of the National Institute of Whole Health, whose educational model is based on wellness and the integration of mind, body, and spirit. She has spent most of her career educating women about the relationship between the mind, emotions, and the hormone cycle.