An injectable birth control drug, medroxyprogesterone acetate (MPA), widely known as Depo-Provera and marketed globally as Sayana Press, is now at the center of growing controversy.
Studies have linked the contraceptive to a higher risk of brain tumors, sparking multiple lawsuits against its manufacturer, Pfizer, and raising concerns about its aggressive promotion in Africa.
Depo-Provera, given every three months, and its newer version, Sayana Press, are promoted as affordable, long-term contraceptives. Sayana Press, designed for self-administration through a patch with microneedles, is unavailable in the U.S. but heavily targeted in Africa and low-income countries. Supporters, including the Bill & Melinda Gates Foundation, claim these contraceptives address family planning gaps and empower women to control their reproductive futures.
However, mounting research has uncovered serious risks. Studies in Expert Opinion on Drug Safety and the British Medical Journal found significantly higher risks of meningiomas tumors around the brain among women using MPA. The risk reportedly increases with prolonged use.
While often benign, meningiomas can cause severe neurological issues such as stroke, seizures, and cognitive impairment. Some are inoperable depending on size and location. Pfizer insists these claims are “without merit,” maintaining the drug’s safety and pledging to “vigorously defend against these allegations.”
Still, Pfizer updated Depo-Provera’s data sheets to warn about meningioma risk with long-term use, advising discontinuation if tumors occur. Several class-action and individual lawsuits are now underway.
Beyond tumors, Depo-Provera carries the FDA’s strictest Black-Box warning for life-threatening side effects. These include irreversible bone density loss, blood clots, stroke, and breast cancer some studies showing a doubled risk. Other dangers include ectopic pregnancy and delayed fertility.
Another alarming concern is HIV vulnerability. High progesterone doses in Depo-Provera thin the vaginal lining, increasing susceptibility to HIV/AIDS and other STDs. Even a Gates Foundation and NIH-funded study advised that women be warned of the “potentially increased risk of HIV-1 acquisition and transmission” with injectable contraceptives and counseled on using condoms for protection.
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