Depo-Provera (Birth Control Shot)

What is Depo-Provera?

Depo-Provera, the birth control shot, is a long-acting progestin (hormone) method of birth control. It is injected every 11 weeks. It is effective 24 hours after your first injection if given in the first 5 days of a normal menstrual period. You will need to receive your injection promptly every 11 weeks in order to continue your contraceptive protection.

How does it work to prevent pregnancy?

It inhibits the secretion of hormones that stimulate the ovaries. This prevents ovulation and thickens the cervical mucus to prevent the entrance of sperm into the uterus.

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How effective is Depo-Provera in preventing pregnancy and STIs?

With continuous use of Depo-Provera, there is less than a 1% chance of experiencing an accidental pregnancy. This rate assumes that no shots are missed.

Depo-Provera does not offer any protection against sexually transmitted infections (STIs). We recommend using condoms with Depo-Provera to protect against sexually transmitted infections.

What are some reasons to use Depo-Provera?

  • Depo-Provera offers very effective pregnancy prevention.
  • If you find it difficult to remember to take medicine every day, Depo-Provera may be a better choice for you than the birth control pill..
  • You are on long-term antibiotics or Accutane.
  • You would be comfortable with having your menstrual periods stop (also known as amenorrhea).
  • The birth control shot does not contain estrogen, another type of hormone that is in many types of birth control, including the pill, patch, and ring. This means the shot can be a good choice for women who cannot take estrogen and for women who are breastfeeding.

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What are some reasons NOT to use it?

  • Women who use the birth control shot may┬áhave temporary bone thinning. It increases the longer they use it. Bone growth begins again when women stop using the shot. Talk with your health care provider about the risks. You can help protect your bones by exercising regularly and getting extra calcium and vitamin D, either through the food you eat or from vitamin supplements.
  • You are pregnant or suspect you might be pregnant.
  • You have abnormal vaginal bleeding that has not been evaluated.
  • You have had a stroke.
  • You have serious liver disease.
  • You are being treated for or have a history of breast cancer.
  • You have or have had blood clots in legs, lungs or eyes.
  • You are allergic to Depo-Provera.
  • If you have or have had anorexia nervosa, migraine headaches, depression, heart disease, high blood pressure, diabetes, liver disease, asthma or a seizure problem, please tell your medical provider. Depo-Provera may make these problems worse.
  • Since it is unclear whether smoking while using Depo-Provera increases the risks of heart attack and stroke, it is recommended that women who use Depo-Provera do not smoke.

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What are the side effects?

The side effects are usually not serious, but it is important to realize that once Depo-Provera is injected, it cannot be reversed or neutralized. You will have to live with any side effects until the medicine wears off in 3 months.

Menstrual irregularities
Bleeding, spotting and amenorrhea (not having periods) are common. After a year of Depo-Provera injections, 57% of women are not menstruating. After 2 years, 68% of women are not menstruating. If you stop getting Depo-Provera injections, your period usually returns within 3 to 10 months.

Pregnancy-like symptoms
These symptoms include sore breasts, nausea, fatigue, and abdominal discomfort. They may occur after the first 4 injections but usually go away. If you experience a spotty darkening of the skin (usually on the face), this symptom may not go away completely.

Weight changes
Weight changes may occur due to increased appetite. Among women experiencing this side effect, the average weight gain is 3 pounds by the end of the 1st year and 5 to 7 pounds, total, by the end of the 2nd year.

Depression
Depression may occur but the cause is unclear. It does go away if you stop using Depo-Provera.

Other symptoms
Other symptoms can include headache, dizziness, nervousness, some loss of scalp hair, some increase in body hair, a decrease in sex drive, leg cramps, and bloating. They may or may not be caused by Depo-Provera. Report any of these side effects to your medical provider immediately.

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What are other medical drawbacks and risks?

Delay in ability to become pregnant
After the last injection of Depo-Provera, it takes an average of 9 to 12 months to become pregnant, 68% of women conceive within 12 months, 83% within 15 months and 93% within 18 months. These rates are not related to the length of time you were taking Depo-Provera.

Cancer
One study found a slightly increased risk of breast cancer, especially for women under age 35. There is no increased risk of ovarian, uterine, cervical or liver cancer.

Osteoporosis
Use of Depo-Provera has been associated with a decrease in the amount of calcium in your bones, which can increase your chance of bone fractures. The rate of calcium loss is greatest in the early years of use. Regular exercise, calcium in the diet or a calcium supplement, and not smoking can help prevent osteoporosis in all women.

Sexually transmitted infections
Depo-Provera does not protect you from sexually transmitted infections (STIs). It is important to discuss STI protection with your partner and to use a condom every time you have sex.

Call your medical provider immediately if you experience any of the following:

  • Prolonged, very heavy vaginal bleeding
  • Unusual swelling or pain in the legs
  • Severe chest pain, sudden shortness of breath or coughing up blood
  • Bad headaches or blurred vision
  • A lump in your breast
  • Persistent pain, redness or bleeding at the injection site

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Where can I get Depo-Provera and how much does it cost?

Depo-Provera is available at Health Services and costs $60 for each shot. If you use your insurance, co-pays will vary by carrier. If you have Brown's student health insurance, there is no co-pay for contraceptives, including Depo-Provera. Brown students can call 401.863-3953 to make an appointment with a medical provider to discuss whether Depo-Provera is right for you.  

Links you can use

To learn more about Depo-Provera, you can visit:

Planned Parenthood

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Disclaimer: BWell Health Promiotion is part of Health Services at Brown University. Health Promotion maintains this site as a resource for Brown students. This site is not intended to replace consultation with your medical providers. No site can replace real conversation. Health Promotion offers no endorsement of and assumes no liability for the currency, accuracy, or availability of the information on the sites we link to or the care provided by the resources listed. Health Services staff are available to treat and give medical advice to Brown University students only. If you are not a Brown student, but are in need of medical assistance please call your own health care provider or in case of an emergency, dial 911. Please contact us if you have comments, questions or suggestions.