Patient also needs to know that the injection needs to be given every 12 weeks, give and take 1 week for it to be effective, but can be administered sooner if spotting occurs. She also has to understand that even though she has a negative pregnancy test she may have to come back during her menses to get the shot if she has had sexual intercourse within the last 14 days. DMPA also increases the risk for osteoporosis but switching to a contraceptive with estrogen is an option once she’s no longer breastfeeding. She can continue to take calcium and vitamin D supplements, and incorporate weight-bearing exercise to her work-out regimen to prevent osteoporosis (Edmunds & Mayhew, 2013). She also needs to be educated on the adverse effects of the medication such as “breast tenderness, allergy, headache, nervousness, dizziness, weakness, and fatigue” (Edmunds & Mayhew, 2013, p.627). Other less common adverse effects are cramping in the legs, vaginal inflammation, whitish vaginal discharge, difficulty sleeping, nausea, hot flash, decreased sexual desires, anorgasmia, and hypersensitivity (Edmunds & Mayhew,