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Teens and Depo-Provera: a good match?


 Participants at the 1995 meeting of the Society for Adolescent Medicine learned that weight gain during Depo-Provera use may be associated with dissatisfaction and discontinuation among adolescents and that adolescents who were on a diet were more likely than those who were not to be engaged in risky sexual behavior (51% vs. 37.5%, respectively, were sexually active) and to worry about sexually transmitted diseases and pregnancy (24.3% vs. 14.4% and 47.5% vs. 24.9%, respectively). In the first study, researchers learned that giving early second injections of Depo-Provera to adolescents did not affect their bleeding patterns and increased the body mass index (BMI) two-fold (e.g., BMI at 3 months, 0.4 vs. 0.99). Teens who used oral contraceptives (OCs) before Depo-Provera were more likely to be satisfied with Depo-Provera than those who did not use OCs (87% vs. 52% on regular injection cycle and 39% receiving early second injections). A possible explanation for weight gain among adolescent Depo-Provera users is that the hormone directly stimulates the brain's hunger centers, thus increasing appetite. The hormone also interferes with serotonin, which influences satiety and stabilizes moods. Another risky behavior among dieters in the second study was alcohol use before sex (23.9% for dieters vs. 14.3% for non-dieters). Heavy dieters were more likely to have been date-raped than both moderate dieters and non-dieters (20.3% vs. 13.8% and 9.2%, respectively). These findings suggest the need for clinicians to screen adolescents for eating disorders before prescribing a contraceptive method. They should discuss dieting, body image, and age at menarche and identify risk factors. Girls who achieve puberty before their peers tend to engage in risky sexual behaviors and to have more depressive episodes during high school.
