Prescription Options

What You Need to Know About Depo-Provera

September 23, 2018

Depo-Provera (medroxyprogesterone) is a reversible system of prescription birth control. Also known as DMPA, Depo shot, or the birth control shot, this progestin-only contraceptive prevents pregnancy for up to 3 weeks with every shot. 

The Way It Works

Depo-Provera is a hormonal contraceptive method that gradually releases the progestin medroxyprogesterone acetate and protects against pregnancy for a period of 11 to 14 weeks.

This works by preventing ovulation and by thickening the cervical mucus. This prevents sperm from entering the fallopian tubes and fertilizing any egg that may have been ovulated.

2 Formulations

There are two versions of Depo-Provera. With the exception of the few differences noted below, both injections work the exact same manner and supply the same degree of pregnancy defense.

Depo-Provera Injection: The first Depo-Provera formula has to be injected into a muscle, either as the buttock or upper arm. You have to have a shot four times each year (every 11 to 13 months ) to maintain Depo-Provera’s high efficacy rate. 1 shot contains 150 milligrams of medroxyprogesterone acetate.

If you get your first Depo shot over the first five days of your period, it gives immediate pregnancy protection. If you receive your very first shot at any time in your cycle, you need to use a backup method such as condoms, for at least the next 7 days.

Depo-subQ Provera 104 Injection:  This version contains 31 percent less hormone than the original Depo shot 104 milligrams of medroxyprogesterone acetate. Since it has a lower dose of progestin, it can result in fewer progestin-related side effects.

The subQ stands for”subcutaneous,” so this newer shot only must be injected under your skin, not a muscle.

It has a smaller needle and may cause less pain. Depo-subQ Provera 104 must be injected into the thigh or abdomen four times a year (every 12 to 14 months ). The degree of maternity protection is just like the standard shot.

You can easily switch from Depo-Provera into Depo-subQ Provera 104 in your next scheduled injection. Should you do so you’ll have immediate pregnancy protection.


Compared to other birth control procedures, there are a number of reasons why Depo-Provera is appealing to many women.

  • The birth control shot is a great alternative if you do not need the trouble of using a daily birth control procedure such as the pill.
  • You only get Depo-Provera injections 4 times annually. As soon as you obtain your own Depo shot, you do not need to think about birth control for weeks.
  • Depo-Provera may make your sessions very light, and they could stop altogether after several Depo injections.
  • It is an extremely successful and reversible prescription birth control option.
  • Depo-Provera does not interfere with having sex, which it allows for spontaneity.
  • It is a discreet and private contraceptive option. Nobody must know that you utilize Depo-Provera because there are no wrappers or tablet compacts.
  • Depo does not include estrogen, therefore it can be a good choice if you cannot tolerate estrogen or use combination contraceptives.
    • Girls that are breastfeeding or are 6-weeks postpartum can safely use Depo-Provera.

    Non-Contraceptive Benefits

    The FDA has also approved the Depo-subQ Provera 104 shot for treating endometriosis-related pain.  Research shows that it treats this pain as effectively as leuprolide, but it is associated with fewer vasomotor symptoms like hot flashes and flashes in addition to significantly less bone loss.

    Depo-Provera offers pain relief mathematically equal to that of leuprolide across all endometriosis-associated places. Including pelvic tenderness and pain, dysmenorrhea (menstrual cramps), painful sexual intercourse, and hardening and thickening of tissue.

    Following a few injections, Depo-Provera generally stops menstruation, leading to thinner, more streamlined endometrial tissue. This, then, can halt the growth of endometrial implants, relieving endometriosis-related pain.

    Depo-Provera can also assist in preventing cancer of the uterus lining. It appears that Depo-Provera use may lower your risk of endometrial/uterine cancer by approximately 80 percent. This protective effect of the Depo shot seems to last for at least 8 years as soon as you stop using it.


    It’s typical for birth control to get disadvantages. Depo-Provera is no different and it is important to know both the pros and the cons before you make a choice.

    • Scheduling is significant and you should  remember to make your injection appointment each 12 weeks. If it’s been over 13 weeks since your last shot (or even 14 weeks as your last Depo-subQ 104 shot), then be sure to use a backup birth control method since you could be at risk for becoming pregnant.
    • The package insert of Depo-Provera includes a black box warning about potential bone loss:”Women who utilize Depo-Provera may lose substantial bone mineral density (BMD).” BMD measures how much calcium is stored in the bones. Using the Depo shot time may result in a calcium loss, but calcium starts to reunite once this method is stopped. As a result of this warning, Depo-Provera is generally not suggested for teen girls.
    • Due to the possibility of bone density loss, it is also advisable that you shouldn’t use Depo Provera or Depo-subQ Provera 104 for over a couple of years.
    • Many women stop using Depo-Provera during the initial year of usage as a result of spotting/irregular bleeding or constant bleeding. This negative effect is especially prevalent during the first 3 weeks of Depo use. Unfortunately, there is absolutely no way to know ahead of time whether or not you will experience these bleeding problems.
    • In a small number of instances, women have experienced skin reactions in the area where they obtained the Depo shot. The skin around the injection may also get dimpled or feel lumpy.
    • Pfizer, the maker of Depo-Provera, recommends that you stop your Depo injections annually before you’d love to become pregnant. It takes an average of nine to 10 weeks (and sometimes a year or longer) to regain fertility and start ovulating after receiving your last shot.
    • Some studies reveal weight gain with all the Depo-Provera shot. The manufacturer claims that girls gain an average of 5.4 pounds the first year and will have gained 8.1 pounds from the end of their second year.
    • Some women report mild pain related to the Depo injection.

    Regrettably, there’s absolutely no way to halt the side effects which can result from Depo-Provera use. There is the possibility that these side effects can last until your Depo injection burns in 12 to 14 weeks.

    Less Common Side Effects

    On the first year of Depo shots, you may notice several changes as your body adjusts. Furthermore, a number of the common side effects include changes in sexual drive and appetite as well as baldness and/or improved hair on the body or face.  In a few women, it can lead to depression, anxiety, dizziness, nausea, or headaches. A skin rash or spotty darkening of the skin or sore breasts might also occur.

    Added Factors

    If you’re currently using another hormonal method, you can change to Depo-Provera. You should receive your first Depo shot within seven days after the final day of using your current method. 

    • When switching from combination birth control pills, organize to receive your first Depo shot over seven days after taking your last active tablet.
    • If switching from the Ortho Evra Patch, plan your Depo-Provera shot within seven days after eliminating your patch.
    • If switching from the NuvaRing, program your first Depo shot within seven days after taking the ring out.

    STD Protection

    Depo-Provera provides no protection against sexually transmitted diseases. You have to use a condom. 

    Who Can Use It

    Depo Provera can be a safe birth control option for many healthy women. It’s important that you discuss your entire medical history with your doctor before receiving an injection.

    Depo-Provera Isn’t Suggested for women who have the following:

    • Breast cancer
    • Thrombophlebitis, a history of thromboembolic disorders, or cerebral vascular disease
    • Risk factors for osteoporosis: bone disease, excessive smoking or alcohol, a family history of osteoporosis, anorexia, or usage of steroid drugs
    • Significant liver disorder
    • Teen women as This is a Crucial period for bone mineralization
    • Undiagnosed vaginal bleeding
    • Wish to become pregnant within the next year

    Connected Prices

    Beneath the Affordable Care Act, many insurance programs must cover physician visits associated with birth control and the shot itself is free under most programs. Medicaid may cover the price as well. Any adjustments to the Affordable Care Act could affect whether insurance plans cover contraception. Check with your own insurance policy to see exactly what your policy and costs may be.

    If you don’t have coverage, you will need to pay out-of-pocket for the medical exam. Your cost might be as much as $250 for your first visit as much as $150 for additional visits.

    Costs for the injections alone vary, but the normal cost for each injection may vary between $30 and $75. The entire cost for a complete year of use might vary from $200 to $600 and can vary if extra office visits are needed.

    You may incur extra costs if you are over two weeks late to your next scheduled shot. Your doctor may expect a pregnancy test before your next injection, and so you will need to pay for that too.


    Depo-Provera is 94 percent to 99% successful.  With perfect use, less than 1 out of every 100 women who use Depo-Provera will become pregnant in one year. With typical usage, 3 out of every 100 women who use Depo-Provera will become pregnant.

    A Word From Verywell

    Because it was initially approved by the FDA, Depo-Provera has been a popular option for birth control. Whether it is ideal for you depends on many aspects. Many women have found that a couple years of regular injections makes handling birth control simpler. Talk with your physician to see whether it’s a fantastic match and be sure to ask any questions you have on the way.