Irregular Periods After Depo Shot: What to Know

Question
I received one shot of depo in may and did not return for my shot in july. During that time i had regular periods however in july after not receiving my shot my period stopped and didnt return until september. Once I did get my period back I had a period every two weeks. Two in september and two in october. The last period which was the end of October was very light basicly spoting for a few days and some days wasnt even enough to wear even a pantyliner. The only time i actually bled was when having intercourse which was very light blood but after that I didnt bleed anymore and the spotting ended. In October and November I did have unprotected sex on more than one occation. So now it has been about 31 days since that last light period started. I assumed when i didnt get another period in two weeks that maybe my body was going back to the regular 28 day cycle. But that has passed and no period. Im not sure if maybe I could be pregnant or if my body is just adjusting. Its weird to have periods every two weeks and then go over 30 days without one. I think it may be too soon to try to take a HPT.  thanks

Answer
Dear Liz,

There is no question that Depo Provera can cause havoc with your cycles. However, from what you have shared, I have the following concerns:

First, bleeding which is brought on by sexual intercourse is never normal and is something that you should be seen by a doctor for.

There are several potential causes for post-coital bleeding (bleeding after sex). Some of these are:
1. Cervical dysplasia: Cervical dysplasia is precancerous changes of the epithelial cells that line the cervix. Risk increases with multiple sexual partners, sex before age 18, childbirth before age 16, or a past history of STDs. Treatment is usually cryosurgery or conization.
2. Chlamydia: A bacterial infection that is usually transmitted through sexual activity or contact with semen, vaginal fluid, or blood.
3. Gonorrhea: A usually sexually transmitted disease caused by a bacteria. Treated with medications.
4. Vaginitis or Cervicitis: Inflammation or swelling and infection of the vagina or cervix. Treatment depends on the cause.
5. Cervical polyps: Cervical polyps are smooth, red or purple, finger-like growths that grow out of the mucus layer of the cervix or the cervical canal. Cervical polyps are extremely fragile, extending out of the cervix, and easily and painlessly removed.
6. Trichomoniasis: A usually sexually transmitted disease caused by protozoan. Can also be passed to newborns during vaginal birth by infected mothers. Although very rare, transmission is also possible in tap water, hot tubs, urine, on toilet seats, and in swimming pools. May cause vaginitis.
7. Vaginal Yeast Infection: An overgrowth of the normal fungi that inhabits the vaginal area. Common symptoms include itching, burning, and an odorless, white, cheese-like discharge. Treated with medication.
8. Endometritis or adenomyosis: Endometritis is an inflammation of the endometrium (the innermost layer of the uterus). Both conditions are associated with endometriosis. Adenomysis is when endometrial tissue attaches itself to the uterus, or another organ such as the ovaries, and grows outside of the uterus.
9. Uterine polyps: Uterine polyps occur when the endometrium overgrows causing these protrusions into the uterus. It is extremely rare for these growths to grow in a way that is either benign or malignant. Women with uterine polyps frequently experience bleeding between periods (metrorrhagia), other symptoms includes vaginal bleeding after sex, spotting, menorrhagia, bleeding after menopause, and breakthrough bleeding during hormone therapy. Hysteroscopic-guided curettage is the preferred treatment, since the normal D&C is basically an unguided procedure that may miss many of the uterine polyps.
10. Fibroid tumors: Uterine fibroid tumors are usually benign tumors. They are solid masses made of fibrous tissue. Fibroid tumors are rarely malignant. Symptoms of fibroid tumors vary among women, with some women never experiencing any symptoms at all. Women who can wait until menopause will see their fibroids shrink and disappear once their bodies stop producing estrogen. It's important that women with fibroids make sure they never take estrogen, in any form including birth control pills, since estrogen increases fibroid growth. Several treatments are currently available for uterine fibroid tumors from myomectomy and uterine artery embolization to the traditional hysterectomy.

Again, because there are a number of causes and nearly all require medical treatment, you should be seen by your doctor with this particular physical symptom.

Second, because you had unprotected sex during the last two months, you cannot dismiss the possibility of pregnancy. You will need to test for pregnancy to know for sure. Although some tests claim accuracy on the first day of a missed period, I usually suggest that women wait until the week after a missed or spotty period before testing for pregnancy (which is typically about 3 weeks after a potential conception date). This tends to minimize the incidence of false negative results and also avoids wasting money on a test for a simple delay of a period by a few days. When/if you test make sure to use 1st morning urine to get a concentrated sample for the most accurate results. Otherwise, when you see the doctor for the post-coital bleeding complaint, they can do a quantitative blood  pregnancy test (serum beta hCG) which can detect a pregnancy earlier and is much more conclusive. This test will give an actual amount of hCG in your bloodstream, rather than just a positive/negative result.

I hope this information has helped you and answered your question. I wish you well.

Brenda