If You Ask Us: Depo and STDs

You may have heard about a recent study linking women’s use of Depo-Provera with increased risk of sexually transmitted diseases (STDs). And you may have wondered: what does the National Women's Health Network think about that?...

The study in question compared rates of chlamydia and gonorrhea infection among two groups of sexually active women at two clinics in Maryland. One group used hormonal contraception, either “the shot” (Depo-Provera) or “the pill” (oral contraceptives). The other group did not use hormonal contraception.

The study found higher rates of STD infection among women using Depo. This in itself does not prove a cause-and-effect relationship, as other factors can sometimes explain such associations. For example, women who choose hormonal contraception might also be more likely to have multiple partners, thus increasing their risk for infection.

However, earlier research findings had raised the possibility that Depo might make women biologically more vulnerable to certain infections. And in this study, the association between Depo and higher rates of STD infection persisted even after taking into account confounding factors like age and number of partners. This is worrisome and important information. But again, it is not proof that Depo use caused the increased rate of infection.

We at NWHN do not believe that this study justifies preventing a woman from choosing Depo-Provera if she makes an informed choice that it is her best option. But we do believe that clinicians should counsel patients who both use Depo and are at risk for STDs about ways to reduce exposure to these infections—such as using condoms (male or female) correctly and consistently, and limiting their number of sexual partners. Women who can’t take these measures or don’t have access to STD screening and treatment may want to consider a contraceptive method that is not associated with increased rates of infection.

Predictably, antichoice activists who oppose family planning have exploited the study to criticize U.S. funding for contraception. Such attacks put women’s health advocates on the defensive and make people hesitant to share information about contraception that isn’t wholly positive. But it’s critically important for women’s reproductive health that we do share such information.

These findings highlight the need for more research in this area and more funding for STD screening and prevention—including development of microbicides that reduce the risk of HIV and other STDs.