Depo-Provera and the Birth Control Pill

Medically Reviewed by Nivin Todd, MD on August 17, 2020

Depo-Provera, or the birth control shot, and birth control pills are two types of contraceptives that use hormones to prevent pregnancy. Both are very effective, but there are some key differences between them. You can switch from one to the other but should consider their similarities and differences first.

Remember, you’ll also need condoms to help prevent sexually transmitted diseases (STDs). The pill and the shot don’t do that.

The Birth Control Shot vs. the Pill

Depo-Provera is a contraceptive injection that contains the hormone progestin. The hormone in the shot stops your ovaries from releasing an egg and thickens your cervical mucus which prevents sperm from reaching the egg. It also thins the lining of the uterus preventing implantation of fertilized egg.

How you take it: You need to get the injection every 3 months for it to continue to prevent pregnancy.

Most birth control pills are made up of two hormones: estrogen and progesterone (except for the mini-pill, which has progestin only). These are “combination” pills. The hormones in them work together to prevent ovulation, the process that triggers your ovaries to release an egg. This type of pill also makes the mucus around your cervix thicker, which makes it harder for sperm to reach the egg.

Sometimes, the pill changes the lining inside the uterus. This can help stop fertilized eggs from attaching to the uterus’s lining.

How you take it: You must take the pill every day around the same time to maximize pregnancy prevention.

Side effects for both methods can include:

Can you take both? Doctors recommend choosing one effective birth control method that works for you. Unless you’re switching from the pill to the shot or vice versa, you probably won’t take both.

Which Option Is Better for You?

Both the birth control pill and the shot are effective ways to prevent pregnancy. To find out which method might be better for you consider:

  • Success rate. Both methods are very effective. Only 6 out of every 100 women who get the shot will become pregnant, which is a 94% success rate. The pill has a 90% success rate overall -- but the success rate is higher when used perfectly.
  • Risks. Most women have little to no side effects after taking the birth control pill, but you shouldn’t take it if you have a history of blood clots, certain cancers, or migraine headaches with aura. You should also avoid the birth control shot if you have a history of any of those conditions or liver disease. Other risks linked to the shot include a loss in bone density in women, which may not recover completely. You should also know that the shot can also lower fertility for up to a year after you stop getting it. And if you smoke, are over age 35, or have had breast cancer, your doctor may recommend that you not take the pill.
  • Your lifestyle. You’ll need to take the pill every day around the same time to get the best results from it. The shot is most effective when you get an injection every 3 months. Before you decide, consider which method will best fit your lifestyle.
  • Cost. If not covered by insurance, birth control pills can cost anywhere from $0 to $50 a month depending on the type. Each injection (which you’ll need every 3 months) can cost up to $150 if your health insurance doesn’t cover it.

Switching From the Pill to the Shot (or Vice Versa)

If you’re thinking of making a change, talk to your doctor. Make sure you have no gaps between methods. You may also want to use a back-up method (such as condoms) during the transition.

If you’re switching from a birth control pill to a shot, get your first shot 7 days before you stop taking the pill. You need to finish you pill pack before you switch methods.

If you switch from the shot to a pill, you can take your first pill up to 15 weeks after your last birth control shot.

You may notice some changes in your period after you switch birth control methods. That’s normal. You don’t need to wait for your period to start before you stop the old method or start the new one.

WebMD Medical Reference



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

American Academy of Family Physicians: “How to Switch Birth Control Methods.”

Kids Health: “Birth Control Pill,” “Birth Control Shot,” “Birth Control Methods: How Well Do They Work?”

Archives of Sexual Behavior: “The Complexity of Multiple Contraceptive Method Use and the Anxiety That Informs It: Implications for Theory & Practice.”

University of Wisconsin Madison School of Medicine and Public Health: “How Pregnancy (Conception) Occurs.”

Contraception: “Multiple Contraceptive Method Use and Prevalence of Fertility Awareness-Based Method Use in the United States, 2013-2015.”

CDC (Reproductive Health): “Contraception.”

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