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Endo Girls
the ongoing saga of bloody pain
Depo Shot Question 
13th-Aug-2012 01:16 pm
Hey there.

I've got a question about the Depo shot. I have so far only got ONE shot. I am due for my second shot on September 6th.

I am on Depo for endometriosis and to stop periods and bleeding (not for birth control, though of course that's an added benefit). Anyway, I went almost two months without a period/bleeding. But, now, today is like the 6th day that I've had a "period." It's not a real period as I know I didn't ovulate, but I am really not happy about bleeding because it's going to cause my endo cyst to grow larger and that is what we are trying to curb happening. Whenever I bleed or have a period, that is what seems to cause my cysts to grow, so we are trying to stop my periods for a while to see if the cyst will shrink/disappear.

I am wondering if maybe I am bleeding now because the progestin dropped off? Maybe I need another shot before the three months? Has anyone ever experienced this? Maybe it's just because it was my first shot and the progestin is still relatively low in my body? Has anyone else had to get their shot more than once every three months, or has anyone had bleeding this early before their next shot was due?

Any experience with this kind of thing happening on Depo?

13th-Aug-2012 05:31 pm (UTC)
I am not a doctor, but I have done lots of research and reading about all this.

My understanding is that it's the estrogen dominance that grows/feeds endometriosis cysts, and hormonal birth control (particularly only progesterone-based ones, like the mini pill and depot provera shot, as well as the mirena iud, as opposed to combination birth control types which contain estrogen as well) shuts off your ovaries, and so hopefully that keeps estrogen from being produced and feeding those cysts (as well as keeping a woman anovulatory). This mimics very early pregnancy to some degree. BUT, we can ovulate on birth control, and the back up is that, because your body thinks it's pregnant, the egg will not implant if it happens to be fertilized. Women can ovulate during pregnancy (and even have a multiple pregnancy with months-apart embryos).

However, also from my understanding, endometriosis growths can produce their OWN estrogen, so even though your ovaries are shut off, your body is still being bathed in a certain level of estrogen. This is why a full hysterectomy/oopherectomy does not always 100% alleviate endometriosis pain (which seems very counter-intuitive).

As far as bleeding, you can bleed during pregnancy, whether you ovulate or not. You can also bleed during a course of hormonal birth control, it can sometimes be called 'breakthrough bleeding'. Some women have such a strong proclivity toward their cycle, that they will maintain that cycle even on the mirena or the depot provera shot. If your bleeding is light, and not accompanied by pain, it may just be your body adjusting to the continuous hormones and the new way your body is working.

I'm mostly just rambling here, I think we need more research aimed toward differentiating between different sub-types of endometriosis, and how we treat them. I.e., endometriosis growths that produce hormones should be cauterized before any type of hormonal therapy, further investigating the breast cancer medications that counteract ALL estrogen in the body (since breast cancer can be fed and maybe even produce? its own estrogen) for women whose endometriosis does produce a considerable amount of estrogen (and so shutting off the ovaries wouldn't help counteract the estrogen dominance).

If your insurance coverage is good, why not ask your doctor to monitor the shrinking of your cyst when you get your shots? I hope the therapies you are on are successful, and I wish I could offer more help :)
13th-Aug-2012 05:41 pm (UTC)
These are some interesting points as well, but of course a lot of the questions you raise will take a lot more research before we understand the disease well enough to medically treat patients based on that kind of information. We can certainly hope for this in the future though! =)
13th-Aug-2012 10:17 pm (UTC)
Thanks. Actually, that is what we have been doing. I go in every so often to get the ovary and cyst checked. I keep hoping it will have shrunk or disappeared completely, but haven't been that lucky yet. I am hoping Depo will do the trick. :-\
13th-Aug-2012 05:35 pm (UTC)
Sometimes you will bleed intermittently the first 1-4 shots. Sometimes it will just be spotting, sometimes it is up to a full period. It may take up to a full year before you stop bleeding entirely. So this is totally normal.
13th-Aug-2012 10:16 pm (UTC)
Thanks. This is good to know. :-)
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