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This medication carries a significant risk of causing bone density loss, which might not fully recover after discontinuation. The likelihood of bone loss is heightened with prolonged use and smoking. It is advised not to use this medication for more than two years unless alternative birth control methods are unsuitable. The teenage and young adult years are crucial for bone development, and using this medication may elevate the risk of developing osteoporosis, potentially causing fractures in later life. Consult with your healthcare provider to discuss the potential risks and benefits of this medication compared to other contraceptive options.

Key Points to Consider:

• Bone Health Risk: Long-term use can lead to decreased bone strength.
• Duration Limit: Recommended for use up to two years unless no other options are viable.
• Age Considerations: Be mindful of use during bone-building years (teens and young adults).
• Smoking Impact: Smoking can exacerbate bone loss effects.
• Consultation: Discuss with your doctor to weigh risks against benefits.

You may experience some mild side effects when using this medication, such as nausea, bloating, headache, changes in appetite, weight gain, tiredness, swelling, acne, hot flashes, breast tenderness, or irritation at the injection site. Vaginal bleeding between periods or irregular menstrual cycles might also occur, particularly during the initial months of use. Generally, these effects are temporary, but if they persist or worsen, it's important to inform your healthcare provider.

A more significant outcome of the medication could be the complete cessation of periods after about a year of usage, which typically resumes once the medication is discontinued. If you miss a period and suspect a missed injection or delay of over 13 weeks between doses, a pregnancy test may be necessary.

Serious side effects are less common but require immediate medical attention. These include persistent nausea or vomiting, mood changes such as depression, changes in sexual interest, swelling of ankles or feet, bone pain, unusual vaginal bleeding, severe abdominal pain, unusual weakness, dark urine, jaundice, or seizures. There's also a potential increased risk of breast cancer, so any breast lumps or nipple discharge should be addressed promptly.

Rarely, serious or life-threatening conditions such as blood clots can arise, presenting as symptoms like shortness of breath, chest pain, confusion, dizziness, pain or swelling in the legs, severe headaches, or sudden vision changes. Additionally, although extremely rare, immediate medical help is necessary if you experience a severe allergic reaction, indicated by symptoms such as rash, swelling of the face or throat, or difficulty breathing.

This overview does not cover all possible side effects, so any unusual symptoms should be discussed with your healthcare provider.

Certain medications can reduce the effectiveness of hormonal birth control by lowering the levels of these hormones in your body, potentially leading to pregnancy. Medications that may cause this include griseofulvin, modafinil, rifamycins (such as rifampin and rifabutin), ritonavir, St. John's wort, certain seizure medications (like barbiturates, carbamazepine, felbamate, phenytoin, primidone, and topiramate), and some HIV treatments (such as nelfinavir and nevirapine). It is crucial to inform your doctor about any new medication you begin, and discuss whether you should use an additional reliable form of birth control. Additionally, if you experience new spotting or breakthrough bleeding, notify your doctor, as this may indicate that your birth control is not fully effective.

Moreover, this medication might affect some laboratory tests (including hormone levels, blood clotting factor tests, and thyroid or liver function tests), which could result in inaccurate results. Ensure that lab personnel and all your doctors are aware that you are using this medication.