January 22, 2014

Depo Provera: A Brief History

"I believe in a woman's right to control her own destiny, but contraception deserves honest and thorough treatment; it cannot be an excuse for bad science."
- Judith Weisz, Chair of the FDA Board of Inquiry and Professor and Head of the Department of Obstetrics and Gynecology, Pennsylvania State University Medical Center.
Image from: http://cinemaguild.com/catalog/women_studies.htm

The discovery of Depo-Provera as a contraceptive began, like many children or scientific discoveries, with an accident--an accident which continues to affect millions of women today.

In the early 1960's, Upjohn received FDA approval to use Depo-Provera to treat endometriosis and spontaneous abortion (approval that was later overturned), when a scientist accidentally discovered that Depo was an effective, long-term form of birth control. Upjohn began lobbying the FDA to approve Depo for use as a contraceptive, and in 1974, that approval was finally granted.

That approval lasted for 2 months. When animal testing revealed an increase in endometrial cancer among rhesus monkeys and beagles injected with Depo-Provera -- tumors that grew in response to Depo doses -- the FDA yanked its approval and rejected subsequent appeals for almost 20 more years.

During this time, Upjohn was conducting dozens of studies in (mostly developing) countries, as well as a large clinical trial (primarily among African American women who were low income) in Georgia. This study, called the Grady Trial, was widely criticized, citing subjects who were uninformed of the risks of the study -- or who had never given consent to be injected -- and the disproportionate number of poor women of color who were targeted for the federally-funded research. Forced sterilizations were once so common among these women that they had coined a term for the practice, "Mississippi Appendectomy"; this mentality was indicative of a strong movement that drove the approval of Depo Provera, and continues to drive its spread across the globe: Population Control.

Population control advocates were a strong push behind the eventual FDA approval of Depo as a contraceptive in 1994. Despite few long-term studies and growing complaints of side effects beyond those few that had been tightly controlled and studied during clinical trials (weight gain, breast cancer risk, and bone mineral density loss being those most commonly cited), Depo continues to be pushed primarily on women of color and the poor.

Depo Use, United States, 1992. From http://cdclv.unlv.edu/healthnv/teensex.html

To be continued...

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