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Depo-Provera (Birth Control Shot)

Medically Reviewed by Traci C. Johnson, MD on June 10, 2022

What Is the Depo-Provera Shot?

Depo-Provera is a birth control method that you can get as a shot. You might hear people call it a contraceptive injection or birth control shot. It’s a manmade hormone, medroxyprogesterone, which is similar to the natural hormone progesterone.

You get the shot in your arm or buttock. If you get your shot at the doctor’s office, your clinician will inject Depo-Provera deep into your muscle or under your skin. You have to get it every 12 weeks to get full protection.

After your first injection, doctors recommend that you use a back-up birth control method (like a condom) for 7 days.

Self-Administered Depo-Provera

You can also get a version of Depo-Provera that you inject at home. This version of the shot is only subcutaneous, which means it goes into your skin instead of deep into your muscle.

Experts call the at-home shot Depo-sub Q Provera 104. It’s a prefilled, single-use syringe with a smaller needle than the one your doctor uses, so it may hurt less. It also uses a lower dose of progestin than the 400 milligrams in the dose from your doctor. You’ll need to give yourself a shot in the thigh or belly every 12 weeks in order for it to work.

Your doctor can show you (in person or through telemedicine) how to inject yourself and safely throw away sharp tools after your shot. It’s important to follow their guidance. At-home Depo-Provera is safe to use. It’s not likely, but if you notice a reaction at the injection site, let your doctor know.

You may notice a lump, dimple, or dent at the reaction site. You may also see redness, bruising, blistering, or itchiness.

If you think something is not right, call your doctor right away. They can help clear up confusion or guide you while you use Depo-Provera at home.

How Effective Is Depo-Provera?

Both the original and at-home versions are 99% effective at preventing pregnancy if you get it every 3 months, as directed. But because that isn’t always possible, typical effectiveness is around 94%. That means for every 100 women who get the shot, about 6 will have an accidental pregnancy.

Here’s how that stacks up against other types of reversible (nonpermanent) birth control:

  • Hormone implant: 99.9% effective
  • Levonorgestrel intrauterine device (LNG IUD): 99.9%-99.6% effective
  • Copper IUD: 99.2% effective
  • Birth control pill: 93% effective
  • Birth control patch: 93% effective
  • Vaginal ring: 93% effective
  • Male condom: 87% effective
  • Diaphragm: 83% effective
  • Sponge: 86% effective in women who’ve never given birth, 73% effective in those who have
  • Female condom: 79% effective
  • Spermicide: 79% effective

How long does the Depo-Provera shot take to work?

Depo-Provera starts to work as birth control right away if you get it within the first 5 days of your period.

What happens if I’m late getting my Depo-Provera shot?

You’re more likely to get pregnant if you’re more than 2 weeks behind schedule in getting your shot. Use another form of birth control to be safe.

How Does the Depo-Provera Shot Work?

The hormone works on your pituitary gland, causing your ovaries to stop sending out eggs. Without eggs, you can’t get pregnant. It also changes the lining of your uterus and the mucus in your cervix. That makes it harder for sperm to reach any eggs that might be released.

Side Effects of the Depo-Provera Shot

These are the same for both the original version and the at-home one. You might notice:

Changes to your menstrual cycle are the most common side effects. After a year of use, about 50% of women will stop getting their periods. If this happens to you, your period should come back when you stop getting the shots.

Long-term use of Depo-Provera may cause you to lose bone mineral density, which makes you more likely to get osteoporosis. Your chances are higher if you've taken the shot for longer than 2 years, especially if osteoporosis runs in your family, if you drink a lot, if you smoke, or if you have other risk factors for the condition.

Withdrawal from Depo-Provera

A few women have reported flu-like symptoms and unusual bleeding after stopping Depo-Provera, but there isn’t much research on whether these things are linked. Other women report symptoms similar to the known side effects.

Who Shouldn’t Get the Depo-Provera Shot?

It’s OK for most people. But you shouldn’t get it if you have:

Your doctor will be cautious about giving it to you if you’re a teenager or if you have:

 

Can I Get Pregnant After I Stop Using Depo-Provera?

You can become pregnant as soon as 3 to 4 months after your last shot. But it takes some people several months to conceive after they stop using this type of birth control. The time frame doesn’t seem to be linked to how long you got the shots.

Benefits of the Depo-Provera Shot

In addition to preventing pregnancy, the benefits of Depo-Provera include:

  • You don't have to remember to take it every day or use it before sex.
  • You don’t have to pause sex to get protection or rely on a risky method like withdrawal.
  • It gives long-term protection as long as you get the shot every 3 months.
  • It's very effective.
  • You get birth control without having to take estrogen.
  • It can make your period lighter and less painful. It might even stop it.
  • It could make you less likely to get endometrial cancer.

Disadvantages of the Depo-Provera Shot

  • Regular doctor visits for the shots can be annoying.
  • You need to stop taking Depo-Provera several months ahead of time if you plan to become pregnant. It might take up to 10 months to get pregnant after you stop using it.
  • It doesn’t protect you against sexually transmitted diseases (STDs). Use a condom for safer sex.

Depo-Provera Shot Cost

Injections may be free or cost up to $150 each, depending on your insurance. They may be cheaper at family planning clinics.

Show Sources

SOURCES:

FamilyDoctor.org: "Depo-Provera: An Injectable Contraceptive."

MedlinePlus: "Medroxyprogesterone Injection."

Sexuality Information and Education Council of the United States: "Talk About Sex."

Center for Young Women's Health: “Depo-Provera® Hormonal Injections.”

Mayo Clinic: “Depo-Provera (contraceptive injection).”

Nationwide Children’s: “Birth Control: The Shot (Depo-Provera).”

Cleveland Clinic: “Depo-Provera.”

CDC: “Contraception: Birth Control Methods,” “Update to U.S. Selected Practice Recommendations for Contraceptive Use: Self-Administration of Subcutaneous Depot Medroxyprogesterone Acetate.”

New Zealand Medicines and Medical Devices Safety Authority: “Medroxyprogesterone and withdrawal syndrome.”

Nemours/KidsHealth: “The Birth Control Shot.”

Kaiser Family Foundation: “DMPA Contraceptive Injection: Use and Coverage.”

Reproductive Health Access Project: “Contraceptive Pearl: Self-Administered Progestin Injection: Depo SubQ.”

UpToDate: “Depot medroxyprogesterone acetate (DMPA): Efficacy, side effects, metabolic impact, and benefits.”

Pfizer: “DEPO-SUBQ PROVERA- medroxyprogesterone acetate injection, suspension.”

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