Birth Control Pill vs. Depo-Provera Shot

Medically Reviewed by Traci C. Johnson, MD on January 25, 2022

What Is the Depo-Provera Shot?

Sometimes called the shot, it’s the brand name of an injection that prevents pregnancy. The main ingredient is depo medroxyprogesterone, a manmade form of the hormone progesterone. You get the shot from your doctor every 3 months.

What Is the Birth Control Pill?

It’s a regular dose of manmade hormones (estrogen and progestin) that you take every day to prevent pregnancy. A less common form called the mini-pill uses only progestin, but the effect is similar.

How Do They Work?

Both the pill and the shot slow the pituitary gland, which helps stop your ovaries from releasing eggs. The drugs also change the surface of your uterus and cervix so it’s harder for sperm to make their way to an egg.

How Fast Do They Work?

It takes about 7 days for the pill to take effect. But to be safe, use extra protection, like condoms, for the first month.

The shot starts to work right away as long as you get it in the first 5 to 7 days of your period. If your doctor decides to start the shot in the middle of your cycle, you’ll need to use condoms as a backup method for a week afterward.

How Well Do They Work?

When you take them exactly as directed, both the pill and the shot are effective. But what does that mean? For the pill, it means you take it at the same time every day. You might hear this called “perfect use.” For the shot, it means you start it in the first 5 to 7 days of your period for 3 months (13 weeks).

With perfect use, you have less than a 1 in 100 chance of getting pregnant no matter what method you use. But most people aren’t perfect. You might miss a day or two on the pill or you may not make it to the doctor exactly 13 weeks after your last shot. This means about 9 in 100 women will get pregnant over the course of the year on the pill and 6 in 100 on the shot.

Other Benefits

Both the pill and the shot can help you out in other ways:

  • You might have lighter periods with less blood and cramping (and sometimes no period at all).
  • You have a lower risk of anemia because of lighter periods.
  • They help prevent certain cancers, ovarian cysts, and other illnesses.

The pill also keeps your period more regular. It tends to start more predictably, about every 28 days. And it could help clear up your skin. The hormones may help prevent acne, though it could take a few months before you see the difference.

The shot could also help with symptoms of sickle cell disease and epilepsy (less seizures). And it could be a good replacement for the pill if you want birth control without estrogen, which can raise your risk of blood clots.

How Do I Get Them?

It depends on where you live. In some states, you need to see your doctor for a prescription for birth control pills. In other states, they’re sold over the counter.

You get Depo-Provera shots from your doctor.

How Much Do They Cost?

  • Depo-Provera: Each shot costs between $30 and $100. Your insurance should cover it, but check your plan to be sure it includes Depo-Provera.
  • The pill: Many insurance plans cover the pill. You’ll probably pay between $0 and $50.

If you don’t have insurance. Family planning clinics will usually provide the pill, Depo-Provera, or some other form of safe birth control at little or no cost.

Side Effects

Most birth control medications have some side effects, though they differ for each woman. Both the pill and the shot could cause:

  • Headaches
  • Dizziness
  • Mood changes, including depression
  • Bloating and belly pain
  • Breast tenderness
  • Changes in your period. It could be heavier, lighter, longer, or shorter than normal.
  • No period. In this case, it isn’t a sign of problems. With the shot, it gets more likely the longer you use it.
  • Weight gain. The shot typically adds about 5 pounds a year for the first 3 years. Young women who are already overweight are more likely to gain weight.

The pill also could lead to an upset stomach, along with more serious but rare problems like blood clots, stroke, and heart attack. These are more likely if you smoke and are older than 35.

The shot can affect bone density. Teens, whose bones are still developing, should choose a different method. Your bones should return to normal after you stop Depo-Provera. Your doctor may be able to strengthen them with diet, exercise, and supplements if you need them.

How Safe Are They?

Though generally safe, the pill might not a good choice if you have:

  • Heart disease
  • Blood that clots easily or genes that put you at risk for blood clots
  • Migraine headaches with aura, numbness, or other problems
  • High blood pressure that isn’t controlled by medication
  • Problems moving around due to surgery or some other issue

Depo-Provera is also generally safe, but it may cause problems if you have:

Talk to your doctor if you notice any of these or you think you’re at risk.

What Happens When You Stop?

It depends on whether or not you want to get pregnant. If you do, it can take 6 months to a year for the shot’s effects to wear off completely. If you don’t, you’re covered for up to 3 months from your last shot. After that, you’ll need another form of birth control.

You can get pregnant as soon as you stop the pill, so if you don’t want to conceive, find another method, like condoms.

Show Sources


Center for Young Women’s Health: “Birth Control Pills: General Information,” “Depo-Provera Hormonal Injections,” “How long does it take the pill to kick in? Say I start the pill on Monday. Can I have unprotected sex on Friday?” 

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

University of Rochester Medical Center: “The Depo-Provera Shot.” “Birth control methods,” “Frequently Asked Questions: Ovarian Cysts.” 

Cleveland Clinic: “Are Contraceptives Containing Estrogen Safe for You?” “Birth Control: The Pill.” 

Cornell Health: “Depo-Provera: The birth control shot.”

Nemours Foundation: “About the Birth Control Pill,” “The Birth Control Shot.”

University of Washington Hall Health Center: “Depo Provera.”

National Health Service: “When will my periods come back after I stop taking the pill?”

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