Contraindications and Precautions for Depo-Provera Use

Conditions Not Considered Contraindications

• A past history of pelvic inflammatory disease (PID) is not a contraindication to Depo-Provera use, as only current PID is considered a contraindication, according to the American Academy of Pediatrics 1
• HIV infection or immunosuppression do not preclude the use of Depo-Provera, as stated by the American Academy of Pediatrics 1
• Adolescent age is not a contraindication for Depo-Provera use, although concerns about bone density require counseling, as recommended by the American Academy of Pediatrics 1

Considerations for Long-Term Use

• The American College of Obstetricians and Gynecologists recommends that use of Depo-Provera beyond 2 years is not recommended unless other methods are inadequate, due to concerns about bone mineral density loss, although this is not an absolute contraindication 1

Contraindications for Depo-Provera

Absolute and Relative Contraindications

• The National Comprehensive Cancer Network (NCCN) guidelines identify a history of stroke or myocardial infarction as contraindications in the context of progestin-based therapy, particularly for patients with a history of cardiovascular events 2, 3
• The NCCN guidelines also list pulmonary embolism or deep vein thrombosis as contraindications for the use of Depo-Provera, due to the increased risk of thromboembolic events 2, 3
• Active smoking is identified as a contraindication, particularly when combined with other risk factors, according to the NCCN guidelines 2, 3
• Depo-Provera should generally be avoided in individuals with a history of neurofibromas or meningiomas, due to evidence suggesting it may stimulate tumor growth, particularly with high-dose depot injections 4