Talk:Depot medroxyprogesterone acetate/Archive 1

message: Whoever put it here was anonymous and apparently unrelated to the various anonymous posters below.
I've rewritten the article, particularly the sections about side effects.  (Many women have severe negative side effects, many women don't, information is good but there's no need to crusade.)  I think it's NPOV enough to justify removing the flag, so I have.  —Bsktcase 23:06, 16 May 2005 (UTC)
thread_title:  NPOV flag removed 

message: According to Chemical castration, Depo Provera, a progestin, is the drug used today for chemical castration. It acts on the brain to inhibit hormones that stimulate the testicles to produce testosterone. Does anyone know anything about this? This article makes no mention of it. -- Ec5618 12:10, 2 November 2005 (UTC)
replies: text: Take a look at this. --JWSchmidt 12:30, 2 November 2005 (UTC)
replies: text: It's been a few months now, and the article still doesn't mention Depo Provera's alternate use in chemical castration. Could someone see to it, please? -- Ec5618 20:35, 1 July 2006 (UTC)
thread_title:  Chemical castration 

message: The issue of this method requiring an injection is probably major reason why people choose not to consider it.  User:Clayboy sensibly removed needle phobia from section entitled "side effects", with edit comment: Side effects - "needle phobia" is not a side effect 4 January 2006.  Below is a copy of our discussion from User:Clayboy talkpage: 
*I agree that needle-phobia is not strictly a "side-effect", but it is in my professional experience seen by patients as a major negative in the cost-benefit discussion of this contraceptive option. The problem is perhaps more of the section title of "Side Effects", but I tried to keep the section headings consistant with other articles on contraception. This point surely does not warrent a separate section of its own, but it does need to be included somehow in the article. My preference is to re-insert the sentance (not bulleted if that seems more acceptable) for the fudged compromise I originally made. However, that is not to deny the validity of your edit comment, so I would welcome your thoughts first. davidruben 23:51, 3 January 2006 (UTC)
thread_title: Needle phobia under Side-Effects ?

message: I know that Depo Provera has been pulled from the market in Canada and possibly other countries.  I was hoping someone could look into this and perhaps add the information to the entry.  Info about how other countries treat medications can sometimes be enlightening, especially with the FDA's notorious reputation.  I would like to add this info myself, but I currently don't have the time to do it.  If it's not done in the future, I may have time to add it!  Any suggestions/comments? Vanessa kelly 10:16, 20 January 2006 (UTC)
replies: text: Recently in Oct'05, General Practitioners in the UK were urged to offer more women long-term methods of contraception rather than just short-term contraceptive pills (i.e. Depo-Provera, IUD/IUS & progesterone implants). See BBC News report re the National Institute for Health and Clinical Excellence's  Press release.  David Ruben  Talk  23:27, 21 January 2006 (UTC)
replies: text:  This article states nothing about depo provera specifically.  I know that there are various injectable contraceptives, in addition to IUD and implants, that can help women use contraceptives without having to remember to take a pill everyday.  While I appreciate the article, it does not answer my question. Vanessa kelly 03:52, 6 February 2006 (UTC)
thread_title:  Additional Information? 

message: I think it's wrong to place the fact some women stop having their periods under a benefit. To many/most women this probably isn't a benefit, (more difficulty telling if you are pregnant, signifies a serious change in your cycle etc.) It is more NPOV to put it more generally under "side effects" and then keep in the brackets that some women may consider this as a benefit.
*I disagree with this, as depo provera is commonly prescribed as treatment for the disease endometriosis. successful treatment and management of this disease require periods to be stopped. In fact it surprises me that endometriosis is not mentioned here- depo is used for this far more than it's used to castrate people, which does get a mention. I think I will add a section as it's a very important use for this drug. LouiseCooke
*Whilst I agree many women often express initial concern or uncertainty over this effect, there is nothing innately beneficial about having periods (vs adequate hormonal axis) as the presence or shedding of endometrial lining gives no health enhancing effect to the woman (assuming no unopposed endometrial hyperplasia is occuring, accepting issue of reassurance not being pregnant and that planned pregnancy can later easily occur). However of those women who do then choose this method, my personal experience is, the main reasons given are roughly equally between problems with other methods, ease of use (not having to remember method each day) or absence of periods. Indeed when the idea was floated a few years ago that those women with absolutely no periods for a few years might require occassional courses of oestrogen to reduce risk of osteoporoisis, many women were distinctly unhappy at the thought of having to manage the nuisance of a period again.
*I wont immediately revert back, but aside from what may or may not be a general benefit vs side-effect to the average woman, there is a clear indication for its use in those women who already have excessively heavy periods (menorrhagia) - see Menorrhagia#Treatment. Would a solution to this conundrum be relevent inclusion in both Benefits and side-effect sections?  David Ruben  Talk  14:32, 13 March 2006 (UTC)
thread_title: Moved stopping periods to side effect

message: Let's all work on reaching a consensus for a new infobox to be placed on each individual birth control method's article.  I've created one to start with on the Wikipedia Proposed Infoboxes page, so go check it out and get involved in the process. MamaGeek (Talk/Contrib) 12:25, 14 June 2006 (UTC)
thread_title:  Proposed Infobox for individual birth control method articles 

message: --Peanut111 19:50, 14 July 2006 (UTC)
replies: text: Whilst personal bad experience is unfortunate and to be regreted, this fails constitute an overall assessment for a drug (anyone having a potential life-threatening allergic reaction to a penicillin antibiotic can reasonably view that drug as harmful, but this is fortunately relative uncommon and a far greater number of patients have benefit from penicillin antibiotics). There is no inherrent reason why having periods is beneficial (other than reassurance not being pregnant), the only reason why combined pill runs with a 4 week cycle (the bleeds are not strictly periods but withdrawal bleeds on withdrawing the hormomnes during the pill-free week) was as a marketing ploy when the combined pill was first introduced: to make it seem more "natural" and thus acceptable. Many women who are greatly troubled with excessively heavy or painful periods are advised to take their combined pills continuously (without a gap) for upto 3 months at a time (unlike progesterone Depo-provera, the oestrogen content of combined pills over a more prolonged time might increase the risk of hyperplasia and thus endometrial cancers). However as you correctly point out, weight gain is possible (but likewise on the progesterone-only pill) but less commonly seen that with combined contraceptive pills (of which max gain I have encountered was 70 pounds). Depo will not stay in the system indefinitely - it is mostly absorbed from the fat tissues (where injected) and broken down over about 3 months, although low levels may persist for a few months more - however the resumption of the normal cyclic hypothalamic-ovarian hormone axis may take some time after this (generally no longer than 6-9 months, but remember for most women normal periods will return much quicker than this). Typically average times to conceive after stopping Depo-provera are about 6-9 months (some as quick as 1 week and other women longer). Depo-provera does not have indefinite perminant affect on weight: I agree loosing gained weight is hard, but equally so does every other person who has found they have gained weight - if being overweight is really something atypical to ones metabolism, one might wonder if some other condition has coincidentally occured (e.g. under active thyroid). Yes concerns have been raised for longterm effects of lower ostrogen levels (re osteoporosis), but suitable high impact exercise, calcium intke and limited years of use may all help minimise this (although not eliminate entirely) - against that compare with combined contraceptive pill which also has risks (DVTs, PEs, strokes, cardiac disease, breast cancer). So no method of contraception is without potential health risks (except perhaps absinance - but that has relationship risk !). Recent UK doctors were officially criticised for not making better use of longterm methods (Depo-provera and IUDs) vs just offering combined pill prescriptions - so yes have problems and good knowledge of this important. Of course even more important is that doctors/nurses properly counsel women over the pros & cons of the full range of contraceptive options. David Ruben  Talk  23:29, 14 July 2006 (UTC)
thread_title:  JUST DONT USE IT 

message: I think that the Depo shot is great. I used the pill prior to the Depo shot, and ended up pregnant with my daughter. After my daughter I got on the Depo shot. I only had a period once every three months, but I was not complaining about it. That was the only side effect that I had. I did not gain any weight, or anything else. I was on the shot for 4 years. And when I decided to stop the shot, it was because I wanted to get pregnant. I was pregnant with my second child with in 2 months. Yes, some consider me to be lucky because for most it takes longer. However, just because you had a bad experience, does not mean that they will, everyone is different. I believe that you should just continue to exercise while you are on it, and you will be fine. And by the way, I am on it again.
:—The preceding unsigned comment was added by 69.154.180.135 (talk • contribs) . 22:07, 16 July 2006
I'm with you. Not having periods is great! It is definitely NOT a negative side effect. I used to have to stay home in bed at least one day every single month, the pain and vomiting were so bad. I gained some weight, but I used to be a size 0-2 (ridiculously tiny for an adult), so that was fine by me. (I am now at size 6-8, or a smallish medium--normal, in other words). I would never let one person's bad experience convince me that no one should use it. I have been using it since early 1997, and have not developed any new health problems I didn't have prior to that. In fact, the article mention the possibility of UTIs as a negative side effect, and my occurence of them actually went *down*. This article in general strikes me as very anti-DMPA, and not very objective at all. It reads more as a warning against DMPA than as an article on a very normal, widely-used medical product/procedure. Emily-—The preceding unsigned comment was added by 24.131.12.228 (talk • contribs) 02:12, 2 October 2006.
:Agree.
:68.255.20.88 08:05, 3 November 2006 (UTC)
thread_title:  Response to the don't use it.  

message: http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=475
weight gain is common/likely with depo, not merely possible.
Cindery 09:42, 14 August 2006 (UTC)
thread_title: re weight gain "possible"

message: Cindery - please review your subsequent edits - I feel this is POV pushing - as Wikipedia reports on accepted wisdom, not to argue out how this is wrong and should be changed. It is not that any specific point is wrong, but more the wording or the emphasis being given. Hence:
*Re lack effect with antibiotics - warnings for effect of antibiotics and COCP are in BNF and form part of FPA guidance - this is de facto official advice in UK and as such should be what wikipedia reports. Cases where this may be pertinant are for women with acne needing repeated pulse courses of antibiotics - the FDA whilst offereing the standard advice re need extra precautions each time antibiotics started, advised me to suggest use of Depo-provera or IUD as alternatives in such cases. The research may indeed be lacking, but this is accepted clinical practice and I have well cited this as being the case.
*Re effects on of ovarian, liver or cervical cancers - notice I had used the phrase "It is not thought ..." and provided a citation for this Br J Fam Plann " Position paper" opinion (). Other studies may or may not support all aspects of this assessment, but one study/paper does not make clinical consensus. 
*re "This study also noted that "children with DMPA exposure during pregnancy and lactation had an increased risk of suboptimal growth in height," but that "after adjustment for socioeconomic factors by multiple logistic regression, there was no increased risk of impaired growth among the DMPA-exposed children." " is superfluous - if after appropriate elimination of confounding biases (not sure that's quite the correct choice of term) no effect seen, then surely no need to qualify the conclusion that it does "not adversely affect the long-term growth"
*To state "At least one of the authors of the study, AZ Lacroix, is a consultant for Pfizer." and then discuss the institution receiving financial support, is to imply a personal assessment of the conflict of interests and thus validity of the paper and its findings - wikipedia is not the place to argue out such assessments (WP:No original research), unless a WP:Reliable sources voices that opinion and thus can be cited.David Ruben  Talk  00:01, 15 August 2006 (UTC)
thread_title: POV pushing ?

message: no conclusion is made, her association with pfizer is merely noted, and from a reliable source. readers can make their own conclusions--that's why it is ethical per the standards of the profession to disclose and note conflicts of interest.  i.e., a journal may publish a study, but it also notes the conflict of interest, so readers can take that into account--the study is not considererd unpublishable, etc.  wikipedia need not be any different (especially since this claim re bmd return only comes from one study--an effect which has been reproduced nowhere else-- and is given so much weight in the article.)  POV pusing would be the opposite--NOT citing the conflict of interest.
Cindery 00:11, 15 August 2006 (UTC)
replies: text: But emphasising the disclosed conflict of interest for this, vs all citations given across wikipedia, is being selective and POV ? The articles themsleves, if from reputable peer-reviewed journal, should be disclosing any possible conflict of interest (thus, it is hoped, showing that the author is being open and not trying to be biased). Likewise problems of methodology should generally not, I believe, be commented in the wikipedia article, the citation link is there for the reader to look at the original article and assess the overall methodology, results and conclusions drawn. David Ruben  Talk  00:27, 15 August 2006 (UTC)
thread_title: re lacroix

message: i'm opposed to selective comparative benefits (but complete listing of comparative advantages/disadvantages would be unwieldy).  hence, the selected advantages/disadvantages should be of note.  the known noninteraction of depo with rifampin does not appear notable (or exclusive to depo).  barrier methods, which do not interact with antibiotics, do not claim this as a benefit, for example.  given the sketchy status of anitbiotic interaction with ocs, and the number of other bc methods with do not interact with antibiotics, it seems like a pushing of depo/strecthing pretty far to find dubious benefits for it.
Cindery 00:11, 15 August 2006 (UTC)
thread_title: re antibiotics

message: not superfluous at all--the socioeconomic factors surrounding depo use are of crucial importance, esp. given pfizer's subsidized title x "buy one get one free" to low-income clinics, and mass use in developing countries. there's also the possibility that "socioeconomic" factors have nothing to with it--the fact is, the study found suboptimal height and then speculated via math. "socioeconomic factors" may ot may not cause the suboptimal height found in depo-exposed children. either way, it's significant.
Cindery 00:19, 15 August 2006 (UTC)
replies: text: All (well virtually all) studies need to use controls and statistical methods to eliminate or quantify bias (otherwise there goes the whole of field of Medical Statistics). The study concluded no overall effect and this is the opinion that citing this source should be verifying. Again lengthy quoting of explanatory findings and interpretation seems, to me, out of place in wikipedia (as being actually debating vs reporting of a debate), and the role of the citation link is to allow the reader to lookup the methodology, results and full conclusions. In part this is question of encylopedic style - we could include dozens of pages I am sure of FDA submissions over any given point/reported side effect, but this would not make for good editorial encyclopaedic writing :-) David Ruben  Talk  00:44, 15 August 2006 (UTC)
thread_title: suboptimal height

message: that is superfluous--we do not, for example, see in every drug article whether or not the drug is associated with ovarian and liver cancer. what is notable is whether it increases or decreases risk. if it has no effect, that's superfluous information.
:Fair point. However if there is particular public (media) concern over say COCP effect on a specific cancer (for sake of this discussion, whether or not true), then may well be of importance for women who wish to start contraception, to choose method not associated with such a risk. This may be more relevant for process of clinical setting and guidelines on advising women of pros/cons of various options, rather than "encyclopaedic" information I suppose. David Ruben  Talk  00:44, 15 August 2006 (UTC)
replies: text: Also if many other methods are associated with some small risk of an additional cancer and one particular method is not, that may in itself make it a notable point (i.e. the contrast to other methods) David Ruben  Talk  00:51, 15 August 2006 (UTC)
thread_title: re ovarian/liver cancer

message: pfizer itself notes this as a risk in the product insert.  (the WHO seems to have tried to bury the cost rica study findings of increased risk of cervical cancer by limiting their review to *invasive squamous cell cervical cancer* only, so that people will read it and think cervical cancer is not a risk with depo, when in fact cervical cancer with depo is merely less likely to be invasive. pfizer knows the risk of cervical cancer is there-- that's why they left the warning on the product insert--they don't want to be sued for failure to disclose.)
Cindery 00:37, 15 August 2006 (UTC)
thread_title: re cervical cancer

message: is exactly that-- a position paper, and a heavily pov one, which might even be called misogynist. it makes a lot of unsupported refs to "bad publicity" for depo in "women's magazines"--as if scientific concern over the safety of depo were not well-established, but merely supersitious b.s. with the gravity of puffpieces about lipgloss.  it also cites no references whatsoever.
Cindery 00:30, 15 August 2006 (UTC)
thread_title: your uk position paper

message: sorry for being so lame. see"6" should now say see"8." here is the link: http://www.multinationalmonitor.org/hyper/issues/1985/02/problems-us.html
 
the quote you are looking to verify re they are "in the population control business" is at the bottom, in a section about "who are the experts?"  the speaker is dr. j crout, former head of fda bureau of drugs.
perhaps it is also useful to mention that the author is amy goodman. she wrote a thesis for harvard on depo provera, and it was published as a series of articles in the multinational monitor and the boston globe in 1985. a list of chapters/sections is here: http://www.multinationalmonitor.org/hyper/issues/1985/02/index.html
Cindery 20:46, 16 August 2006 (UTC)
replies: text: No it should not say "see"8."" - a link is required not a self-referential remark about wikipedia. In line links are, I believe, poor style of giving citation and make a real mess to an article that is using the more expansive cite.php ref-tagged system.... there I've had my grumble :-) David Ruben  Talk  01:57, 17 August 2006 (UTC)
thread_title: mess i have made of references in controversy section

message: the link to the popline document (controversy section, referring to FDA official transcript of proceedings/evaluation of the value of upjohn's studies) seems only to last 24hrs, twice now--it may automatically expire every day? if so, i'm not sure what to do about it--scan somehow and store? provide document # and link to popline database? provide full text(below) as addendum? (i think that would take up too much space...)
Cindery 23:38, 17 August 2006 (UTC)
thread_title: disappearing link

message: i removed references to net en because we don't need to know about other injectables to understand mechanism of action of depo. (also because there's no wiki page for net en, and it isn't explained/discussed anywhere else in depo article--mentioning it is just confusing for readers who don't know what net en is).
Cindery 17:59, 30 August 2006 (UTC)
thread_title: net en

message: the article by sara littlecrow is a publication of the well-regarded pop-dev program at hampshire college. littlecrow clearly states that there is no established link between enhanced hiv transmission and humans, and notes the monkey studies which have caused concern in footnote below:
11. Marx, P., Spira, A., Gettie, A., Dailey, P., Veazey, R., Lackner, A., Mahoney, C., 
Miller, C., Claypool, L., Ho, D., & Alexander, N. Progesterone Implants Enhance SIV 
Vaginal Transmission & Early Virus Load Nature Medicine Vol.2 No.10 October 1996. 
the monkey studies, incidentally are of concern to a number of writers/this can be found in a number of places, i.e., not just her opinion, but part of her research.
i have no idea why you would note her racial or ethnic identity in the article, unless you mean to imply that "native american health care activist" is a derogatory term/implies that she is not qualified to write articles for academic organizations (they seem not to agree with you).
Cindery 19:54, 4 September 2006 (UTC)
thread_title: "native american"

message: i would say the burden is on you to research the subject and prove that it is only her opinion (especially as she cites a study, and the same study is cited in the herpes study). i could go and add several refs to the one that is already there, but the google search is your job if you want to claim that it is only her opinion.
Cindery 20:52, 4 September 2006 (UTC)
thread_title: "woman"

message: I'd propose reverting to the August 30th version. I understand that two of the disadvantages were disputed by  68.253..., but I do not agree with the solution to this conflict (i.e. filling the article with a large quote). The previous version was fine. It made a concise statement, and it was supported with a citation. I like how this section was previously a bulleted list of points with fairly short sentences/statements describing each point. If I am viewing the page history correctly, it seems 68.253... cherry picked a quote to purposely shed doubt on the statement (that was already cast speculativly, saying "may" instead of "does"), and then Cindery added even more of the quote to contextualize it, and highlight other points, when in actuality, the page, in my personal opinion, was better before any of the quotes were introduced (writing so much on such a small point is giving it undue weight when compared with the other points listed). Maybe a compromise still needs to be worked out, such as moving some of the controversial points to a controversies section (that is if they are actually controversial in cited sources, not controversial to 68.253... personally). But for the time being, would both editors support reverting to an earlier version and trying to work things out on talk?--Andrew c 21:57, 5 September 2006 (UTC)
thread_title:  Long quote 

message: Removed clinically irrelevant, intentionally misleading and deceptive statement:
::(In monkey studies, however, Depo is associated with a higher risk for endometrial cancer.)
* Data on DMPA have shown a number of noncontraceptive and therapeutic benefits, the most prominent of which is an 80% reduction in the risk of endometrial cancer. 
* The relative risk of endometrial cancer was estimated to be 0.21 in women who had ever used DMPA. The reduction in risk of endometrial cancer is at least as great for DMPA as for combined oral contraceptives.  
* In one unpublished 10-year study of DMPA begun in 1968 at the International Research and Development Corporation (IDRC) of 52 female Rhesus monkeys (4 controls + 3 groups of 16 receiving the equivalent of 1, 10, and 50 times the human contraceptive dose), 2 monkeys in the highest dose group (equivalent to 50 times the human dose) developed endometrial cancer. 
* After reviewing proposed guidelines from a February 1987 WHO symposium to change safety testing of contraceptive steroids to reflect current scientific opinion, in November 1987 the FDA revised its nonclinical (animal) testing requirements for contraceptive steroids, eliminating the requirement for long-term testing in monkeys (that had been in place for over 19 years) because it did not predict carcinogenicity in humans. 
68.253.189.62 18:55, 6 October 2006 (UTC)
thread_title:  endometrial cancer 

message: i think, though, that anon has a point about fibromyalgia--i can't remember if i put that in because it was in the full text of the article (which i don't have access to right now) or if i did that because it is the only neurodegenerative disease complained about by depo users.  since the citations for the depo users who complain of fibromyalgia are messageboards/blogs and hence not WP:V sources, it is probably better to stick to wording of citation--i didn't do that because 1) wikilink to "neurodegeneration" is a really uniformative stub 2) i think it sounds scarier than fibromyalgia.  but, standard is verifiability, not truth, so neurodegeneration it is. i dunno, if fibromyalgia sufferers who used depo are then upset--a fibromyalgia controversy section could be added--they are reliable sources on themselves/that's the only circumstance under which they are RS.
Cindery 02:41, 3 November 2006 (UTC)
thread_title: neurodegeneration

message: Yes, it does appear that we have had this argument before, and that the same anon who objected to a source by calling her a "native american women's healthcare activist" is the anon who used the "inbred mice" edit summary, etc and has deleted cited WHO content, and would prefer to delete citations from disadvantages section--
so far, I have that the following anon IPs are the same:
68.253.177.143/
68.255.20.88/
68.253.189.62/
69.208.178.182/
Cindery 08:47, 3 November 2006 (UTC)
thread_title: anon IPs all the same

message: The majority of this article has been written by a single editor who persistently and blatantly violates WP:NPOV, WP:NOR, and restores inaccurate information, using Wikipedia as a soapbox to push their POV that Depo-Provera (and most other contraceptives) are dangerous products foisted on women by a conspiracy of greedy and malevolent corporations, public health organizations and physicians.
68.255.20.88 08:05, 3 November 2006 (UTC)
thread_title: = flag article's factual accuracy and NPOV as disputed 

message: Hi Andrew, first of all, the article is not about "Depo Provera use in humans"; it is about the drug in general, and so any information about the drug that is published by a reliable source may be used. Even if it is a study with a minority conclusion, it may still be used. However, it should not be used to draw conclusions that the study itself did not draw. It should simply be described, sticking closely to what the authors of the study said, and going no further. SlimVirgin (talk) 03:41, 3 November 2006 (UTC)
replies: text: Thanks for the imput. When writing up my summary request for comment, I was thinking that would be a good solution. Don't drawn new conclusions from the study, or make it seem as if the results fit under a category they don't, but instead relay them in a manner that is representative of the study in question (this fixes the OR and RS concerns, but still, there are questions about notability and NPOV). --Andrew c 15:24, 3 November 2006 (UTC)
thread_title: comment from SlimVirgin

message: Our source (which is summarizing a primary source) says While clear links between HIV transmission and Depo-Provera use have not been established, preliminary studies on female rhesus monkeys receiving progesterone (the main hormone in Depo-Provera) found them eight times more likely to contract SIV (a monkey version of AIDS) than a group not given progesterone. In these studies, it appeared that the progesterone significantly thinned vaginal linings and made it easier for SIV to enter the body. We say Depo Provera may enhance HIV transmission.
Our source says  Mice immunized with an attenuated strain of HSV-2 2 weeks after Depo-provera treatment failed to develop protection when challenged intravaginally with wild-type HSV-2. In contrast, mice given progesterone and immunized at diestrus or estrus were completely protected from intravaginal challenge. These studies show that Depo-provera treatment changes susceptibility and local immune responses to genital HSV-2 infection. Animal models and vaccine strategies for sexually transmitted diseases need to consider the effect of hormone treatments on susceptibility and immune responses. We say Depo Provera may simultaneously increase susceptibility to the herpesvirus and decrease immune response to the herpesvirus.
I think the placement and wording is problematic. These points are listed under Disadvantages & side effects. The majority of the points in this section deal with human studies, and say as much women under 35,  Fifty percent of women, and Infants born to women. The more less establish points are qualified as A study of 819 women in one city and in one study. I think there is a seperation being created that is subtly misleading. I would at the very least change the wording to say something along the lines of One study linked rhesus monkeys with progesterone implants (similar to, but not identical to depo) to an eightfold increase in SIV contraction. or A study in mice found that those treated with depo were more susceptible to HSV infection, and had  decreased local immune responses to the virus. 
And this brings up another issue, the SIV study doesn't even deal with depo. It delt with progesterone.  The HSV study says progesterone works were depo doesn't. Is the SIV study even relevent? It's only supported by a secondary source. We've removed cited secondary sources in other articles (remember the pill that prevents cancer news articles?)--Andrew c 19:44, 3 November 2006 (UTC)
replies: text: I'm sorry for the confusion. I agree completely that a study on depo (even in rats) is completely relevent here. My concern was the way it was worded, and the way it was simply listed along side the bone loss warning. My solution to this problem was to slightly reword to explain it was only one study in rats, and to create a section seperate from the known, listed warnings, that cover other cited, verifiable, and reliable studies (that either need more study, or are not significant enough to be listed as warnings and precautions on the drug label). I hope we can agree on this solution. I also added the warning listed between cancer and bone density warnings on the label, menstrual disruption (temporarily forgetting it had its own section already in the article). I believe it fits better where it is now, so hopefully that move wasn't controversial. Sorry I went and solicited outside imput on this conflict. I have been avoiding conflict recently, and also felt that both parties had fairly good arguments supported by policy, that others could give a 3rd opinion on matters. I feel we worked out a good solution. We addressed anon's concerns that single studies on animals were being listed along side published, black box warnings for why the drug can be harmful. And we addressed (hopefully) your concerns about deleting cited, verifiable content.--Andrew c 22:48, 3 November 2006 (UTC)
thread_title: Wording of our sources

message: Excellent idea--good edit.
(I think the HIV research has more updates, but can be tweaked later)
Cindery 22:32, 3 November 2006 (UTC)
replies: text: Thank you :)--Andrew c 02:39, 4 November 2006 (UTC)
thread_title: related studies section

message: The references in the WHO paragraph seem off. There are 2 external links, and one foot note. One of the external links is dead, another one doesn't mention AGI (so maybe it is misplaced). I was wondering if anyone (probably Cindery) had the time to look those over and perhaps fix them up? I'd appreciate it. And maybe, as a compromise, add a short clause in the WHO section that desribes the critical comments regarding drug money from the Seattle times article. Something like "The WHO, whose objectivity has also been criticized for receiving donations from pharmaceutical companies,..."--Andrew c 22:56, 3 November 2006 (UTC)
thread_title:  References and WHO 

message: I have to say it's not really appropriate for an experienced editor to delete content for which citations have been provided on talkpage (meaning, there will presumably be ongoing discussion over whether to cite product insert, or the studies therein, etc). Even if you had an objection to the way the source was temporarily cited, I believe you aware that the appropriate thing to do is insert , and continue ongoing discussion on talkpage--bad faith to delete content on "technicality" when you are aware there is cite/are multiple cites...(and aren't you up to 2RR on this and Pfizer/LaCroix in less than two hours, shortly after arguing with me on EC talkpage, and never having editing this article before???)
Cindery 02:44, 4 November 2006 (UTC)
replies: text: Thank you for the accusation of bad faith. Please read WP:CITE. Regarding unsourced assertions, it states that "If it is doubtful and harmful, you should remove it from the article." Claiming a link to breast cancer without a citation is harmful. Putting (Pfizer) in parentheses is not a citation. The appropriate link is to the package insert you forwarded above. You still haven't put this in the article, so I'll do it. But at the time you (re-)inserted the claim, I could find no source, you had provided none, the claim is potentially harmful, and as the person inserting the claim it's incumbent upon you to source it properly. I'm sorry I'm a newcomer, but there are no seniority benefits here. As a separate issue, to be an accurate representation of your source, you might want to quote the lead sentence on breast cancer risk, which states that long-term studies have found no overall increased risk of breast cancer with DEPO, along with the subsection on subgroup analysis. MastCell 05:33, 4 November 2006 (UTC)

text: Since you've studied my edit history, you perhaps realize that engaging in edit wars or revert-a-thons is not my style at all. However, you may have also noticed that I feel strongly about citing sources, especially on medical articles. I don't revert claims that have a reliable citation. However, I will remove any potentially harmful, unsourced claims in accordance with WP:CITE. You need to add a citation for such edits at the same time as the claim. Period. It's considered rude to put provocative, unsourced claims in an article and then attack editors who request that you supply a source. I'd suggest you review the citation process and policy since you continue to think I was being unreasonable. I'll ignore your more condescending comments, as you seem to be trying to push my buttons, and repeat that the issue is not my familiarity with the relevant studies, or my insecurity about how long I've been editing. The issue is simple: you need to cite sources. Otherwise your edit risks being removed until you include the citation. I'm quite familiar with the data on Depo and breast cancer, but my personal knowledge (or yours) doesn't obviate the simple fact that an adequate citation is required. This is not me being a renegade; this is Wikipedia policy. If you spent the same amount of time sourcing your edits as you do accusing me of bad faith, rudeness, "2RR", and personal attacks, this discussion would be unnecessary. MastCell 16:05, 4 November 2006 (UTC)
thread_title: breast cancer