Longman, Phillip.The Empty Cradle: How Falling
Birthrates Threaten World Prosperity and What to Do
About It. New York: Basic Books, 2004. Rejects the
conventional wisdom and emphasizes the nega-
tive aspects of a declining population.
Russell, Cheryl.Demographics of the U.S.: Trends and
Projections. 2d ed. Ithaca: New Strategist, 2003. A
well-organized work that includes tables and
graphs on American society from 1950 to the
early twenty-first century. Highly recommended.
___.Racial and Ethnic Diversity: Asians, Hispanics,
Native Americans, and Whites. Ithaca: New Strate-
gist, 2002. Statistical information, analysis, and ta-
bles based on the census of 2000. Excellent for re-
search papers.
Thomas Tandy Lewis
See also African Americans; AIDS epidemic; Asian
Americans; Blended families; Demographics of Can-
ada; Drug use; Employment in the United States;
Health care; Illegal immigration; Immigration to
the United States; Income and wages in the United
States; Native Americans; Poverty; Women in the
workforce.
Depo-Provera
Definition Injectable contraceptive
Manufacturer Pfizer
Date Approved by the Food and Drug
Administration on October 29, 1992
Depo-Provera, the most effective form of artificial birth con-
trol for women since the advent of the birth control pill in the
1960’s, received approval from the U.S. Food and Drug Ad-
ministration in 1992. It subsequently enjoyed brief popu-
larity as a treatment for male sexual offenders since it also
reduces testosterone levels.
In the 1960’s, “the pill” revolutionized birth con-
trol. While a steady stream of contraceptive innova-
tions were expected to reach the market in the next
decades, few new contraceptive methods were in-
troduced. In the 1990’s, only three new methods re-
ceived approval from the Food and Drug Adminis-
tration (FDA). Norplant, a hormonal implant,
quickly became engulfed in product liability law-
suits, while the female condom proved too awkward
to attract much of a market. The third new form
of birth control, Depo-Provera, is an injection of a
high dosage of progesterone that has a 99.7 percent
effectiveness rate. Nevertheless, the injectable con-
traceptive took more than twenty years to obtain
FDA approval.
Depo-Provera, or medroxyprogesterone acetate,
prevents pregnancy for three months. Thus, women
using the contraceptive have to receive four doses
per year. Administered as an injection into the mus-
cle at the back of the arm or in the buttocks within
the first five days of a woman’s period, Depo-Provera
tricks the body into thinking it is pregnant, thereby
halting ovulation. There is no egg present for sperm
to fertilize. More than half of women on Depo-
Provera for a year stop having periods.
In 1995, an injection of Depo-Provera cost $65,
making it marginally more expensive than the pill.
However, women using the pill have to remember to
take it every day. One of the major advantages of
Depo-Provera is that it is not dependent on user
compliance. This advantage also proves a disadvan-
tage. If a woman experiences adverse side effects,
there is no option except to wait for the drug to wear
off. Many women using Depo-Provera have reported
gaining an average of ten to twelve pounds, while
premenstrual syndrome (PMS) and bone loss could
also be intensified.
Because Depo-Provera lowers testosterone levels
in men, it became a popular form of chemical castra-
tion for male sexual offenders in the 1990’s. How-
ever, many critics maintained that the motives for
sexual assault involved more than sexual drive and
that chemical castration often proved ineffective,
particularly if the offender did not receive counsel-
ing along with the drug. Civil libertarians argued
that the treatment violated the Constitution’s
Eighth Amendment provision against cruel and un-
usual punishment. Nevertheless, a half-dozen states
approved weekly Depo-Provera shots for sexual of-
fenders in the 1990’s.Impact By the end of the 1990’s, Depo-Provera
held about 2 percent of the contraceptive market in
the United States. Fear of lawsuits as well as the long
and expensive process of receiving FDA approval
has hampered the development of new drugs for the
U.S. market. New contraceptives in the United
States are more apt to represent refinements on ex-
isting products, such as nonlatex condoms, than
new approaches.The Nineties in America Depo-Provera 253