Expert: Norman Solberg - 6/13/2011

Question
Hi,
I am 21 years old, and started taking Depo-Provera shots in January. Since my first shot, I have had spotting the second two months of each shot. So Feb and March, and then again May to now, when I got my third shot. Upon getting my third shot, they checked for infections because the continuous spotting was abnormal. I have bacterial vaginosis, so they put me on metronidazole. Now, it was about a week between the shot, and the prescription. In that week, usually my period would have stopped, but instead there is a brown discharge. I assumed this was because of the BV, but now after 3 days (6 pills of MND), there is still brown discharge. My OB-G suggested taking Ibuprofen, three times a day, anywhere from 100-300mg a time, to stop spotting. I did that today and there is still brown discharge. She also told me that after this shot, if I didn't stop spotting I would probably have to try another birth control. But I really like Depo! It is easy and very effective. Is the brown discharge because of the BV and the medication, or am I still spotting from depo? Should I recontact my doctor? How long should I wait before this is supposed to clear up?

thank you!

Answer
The most common side effect of Depo-Provera is irregular bleeding.  It's especially common the first 6 months.  There may or may not be any pattern to it.  I doubt that it has anything to do with the BV or metronidazole.  You're still protected from pregnancy, which Depo does very well.  For most women, irregular bleeding or spotting will get much less after 4-6 months, and some women stop having periods.  I doubt that ibuprofen will make much difference.  Time will.  I would try to put up with the bleeding/brown discharge at least until July (6 months).  Most likely it will be better or gone by then.