Shana received her first medroxyprogesterone (Depo Provera) injection 6 weeks ago and calls the clinic with a concern that she has been having a light "period" off and on since receiving her Depo shot. What would be the management of Shana?
1. Reassurance that some spotting is normal the first few months of Depo and it should improve.
2. Schedule an appointment for an exam as this is not normal.
3. Prescribe 4 weeks of estrogen to treat the abnormal vaginal bleeding.
4. Order a pregnancy test and suggest she use a back-up method of contraception until she has her next shot.
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