I never really actively sought out birth control. Meaning to say, yes, I use protection when the situation arises, but I've never had a consistent one in the long-run. I've considered getting on the pill, but I didn't want to commit to taking a pill at the same exact time every single day if I wasn't even committed to anyone. But I've come to realize that no matter the relationship status, the risk of unwanted pregnancy—and of course, STDs—aren't worth it, so I looked at my choices.
I first learned about the birth control shot aka the Depo-Provera injection while living in New York. I just didn't want to have a pregnancy scare whenever I had sexual intercourse. I couldn't spend around $60 (close to P3,000) on a morning-after pill every time, either. It was probably me just being paranoid but while condoms were good and all, I didn't want to rely on just one thing to keep me safe. I set up an appointment with my school's Women's Health center to look for birth control options that would fit what I was looking for.
Getting the Depo-Provera injection
Before my doctor's appointment, I was sent links to resources like Planned Parenthood to know more about which option would be best for me. I didn't want to take anything on a daily basis because it would be hard to keep up with and I wanted something more low-key. As someone generally afraid of medical procedures, I also didn't want something to be inserted inside me. After deciding what I was and wasn't comfortable with, I narrowed down my search to the birth control patch and the Depo-Provera shot.
The injection site felt heavy and a bit sore for a day or two but it was such a small payoff compared to three months of safety.
After consulting with my doctor, we came to the conclusion that the shot would be the best option for me. The birth control patch currently isn't available in the Philippines so I wouldn't have a way to change into a new one when I came home. I was immediately sold on the Depo shot because I only had to take it every three months and I would be 99 percent safe from unwanted pregnancies. I could also continue taking it even when I came home to Manila.
I was just a few days into my period when I got my first shot, so my doctor said I would be protected from pregnancy immediately. If I wasn't on my period, she said I could still get the shot any time, but I had to wait two weeks for it to be fully effective. I waited more than two weeks anyway. I'm not the biggest fan of needles but the pain isn't all that different from what you would experience from your regular flu shot. The injection site felt heavy and a bit sore for a day or two but it was such a small payoff compared to three months of safety.
The services I received were free because of the medical insurance included in my tuition fee. But when the pandemic hit and I had to come home to the Philippines, I had to start looking into how to continue getting my birth control shot in Manila. I received my first dose of the shot in the Philippines from Dr. Ma. Virginia de Paz Cruz, Obstetrician Gynecologist at VPC Marikina OB GYN Ultrasound Clinic, who's been in practice for 26 years. I asked her a few more questions about the shot and how to get it in the Philippines.
How does the birth control shot work?
The birth control shot uses hormones to prevent pregnancies. According to Dr. Cruz, "Depo-Provera is a progestin-only contraception given every three months. It suppresses ovulation, keeping the ovaries from releasing the egg, while also thickening the cervical mucus to keep sperm from reaching the egg." In case you need a refresher, if the egg isn't released from the ovary, it can't get fertilized by sperm. The sperm also can't fertilize the egg if it can't reach it. It's essentially, well, a cockblock. While it's 99 percent effective in preventing pregnancies, it has no effectivity in preventing STDs.
One of the biggest advantages of Depo-Provera for me is that it doesn't require taking something daily, which means it's also easy to hide from judgmental eyes.
What should I consider when taking the shot?
One of the biggest advantages of Depo-Provera for me is that it doesn't require taking something daily, which means it's also easy to hide from judgmental eyes. Plus, if you're getting caught up in the heat of the moment, it eliminates the need to interrupt sex for contraception. It changes some of your bodily functions, too. "It decreases menstrual cramps and pain, lessens menstrual blood flow, and in some cases, stops menstruation. It also decreases the risk of endometrial cancer," Dr. Cruz explains. The shot's temporary effect also means you can start trying to get pregnant after you stop using it. During my first consultation, I was also warned that side effects might include weight gain. It wasn't something that I experienced personally and it may vary from person to person.
Just like with any injection, you also have to consider that you'll be making regular visits to your doctor which could be inconvenient. While it could lessen menstrual blood flow, it could also cause irregular menstrual periods, according to Dr. Cruz. You also can't tell when the effect finally stops, so that means you need to stop taking Depo-Provera several months ahead of time if you plan to become pregnant. "Depending on your body's response, it can take as early as two weeks to as late as nine to 12 months before its effects wear off." There's also a limit to how long you can take it. Dr. Cruz says, "Ideally, it should not be used more than two years since it may decrease the amount of calcium in your bones." It's best to check with your doctor first to see if this is going to be an issue.
It's important to note that the shot doesn't protect the user from STDs. The doctor I consulted in the U.S. emphasized that you should still use condoms during intercourse, especially if you have multiple partners. It would be best used if you're in a mutually monogamous relationship, so make sure to clear things up (read: DTR) with your partner beforehand.
Dr. Cruz adds, "I usually tell my patients to think over what type of contraception would best fit them. If they are the type of person who can religiously take medicine daily and wants to have monthly menstruation, then combined pills is for them. If not, they can try Depo-Provera because of its three-month effect and convenience. But they should expect irregularities in their menstruation. You can have menses monthly, after two to three months, or even have spotting or heavy bleeding for days to weeks."
Am I allowed to take it if I have preexisting health conditions?
Dr. Cruz says: "Most people can use the Depo-Provera injection, even those who cannot use the combined contraceptive pills. It can also be used for breastfeeding mothers, patients with heavy and painful menstruation and if you do not want to take medications daily." She adds, "You should not take the Depo-Provera injection if you have had breast cancer, liver disease, blood clots or unusual vaginal bleeding (consult a doctor first) and if you are planning to get pregnant in the next few months."
How can I get the shot and how much does it cost?
Dr. Cruz says that, "The best and safest way to use the injection is to have the injection at OB-GYN clinics and family planning clinics." She suggests to get the injection done within your first five days of menstruation. The next injection is scheduled every 12 weeks. She also suggests to stick as much as possible to the scheduled dates of next injections. "It's effective alone but if you missed your shots, it's better to have a back-up or other birth control methods before your next shots."
Personally, I had to shell out around P600 for the medicine itself and to get it administered. For me, it was a reasonable and sulit cost for something that would last three months. (That's just P200 a month or around P6 a day!) According to Dr. Cruz, the price and payment options depend on your clinician and service provider.
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