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Depo Provera

"The Birth Control Shot"

By

Updated July 02, 2014

Depo Provera

Depo Provera Shot

Photo Courtesy of K. Price

Depo Provera:

DMPA, more commonly known as Depo Provera, is a reversible method of prescription birth control. Also known as the Depo Shot or the birth control shot, this method is available through injection. The "D" stands for depot -- the solution in which the hormone is suspended.

How Depo Provera Works:

Depo Provera slowly releases the progestin medroxyprogesterone acetate and protects against pregnancy for a period of 11 to 14 weeks.

How It Is Used:

Currently, there are two different versions of Depo Provera. With the exception of the few differences noted below, both injections work the same way and provide the same level of pregnancy protection.

  • Depo Provera Injection: The original Depo Provera formula must be injected into a muscle and is injected into either the buttock or upper arm. You must have a shot 4 times a year (every 11 to 13 weeks) to maintain Depo Provera’s high effectiveness rate, and you are protected from pregnancy immediately after receiving each dose. This option contains 150 mg of medroxyprogesterone acetate.

  • Depo-subQ Provera 104 Injection: This is the newer version of the original Depo shot. Depo-subQ Provera 104 contains 31 percent less hormone than the original Depo shot (104 mg of medroxyprogesterone acetate). Because it has a lower dose of progestin, it may lead to fewer progestin-related side effects. The subQ stands for subcutaneous, which means this newer shot only has to be injected under the skin (not into a muscle), so it has a smaller needle and may cause less pain. Depo-subQ Provera 104 must be injected into the thigh or abdomen 4 times a year (every 12 to 14 weeks). It also provides immediate pregnancy protection.

Advantages:

  • The birth control shot is great alternative for women who don't want the hassle of daily birth control

  • Depo Provera injections are only required 4 times a year

  • It may make periods very light, and periods may stop altogether after a few shots

  • It is a highly effective and reversible birth control option

  • Does not interfere with having sex and allows for sexual spontaneity

  • Is a private and discreet contraceptive choice

  • Does not contain estrogen, so it can be good alternative for women who cannot take estrogen

  • Women who are breastfeeding or are 6-weeks postpartum can use Depo Provera

Non-Contraceptive Advantages:

The Depo-subQ Provera 104 injection is the first new remedy in the last 15 years to be FDA approved for the treatment of endometriosis-related pain. According to research provided by Pfizer, the manufacturer of Depo Provera, Depo-subQ Provera 104 treats endometriosis pain as effectively as leuprolide yet is associated with fewer vasomotor symptoms (like hot flashes or sweats) and significantly less bone loss. In fact, Depo Provera yielded pain relief statistically equivalent to that of leuprolide across all endometriosis-associated areas -- pelvic pain, pelvic tenderness, dysmenorrhea, painful intercourse, and hardening and thickening of tissue.

After a few shots, Depo Provera usually stops menstruation, resulting in thinner, more compact endometrial tissue. This, in turn, can stop the growth of endometrial implants, relieving endometriosis-related pain.

Depo Provera can also help to prevent cancer of the lining of the uterus.

Disadvantages:

  • The package insert contains a black box warning about possible bone loss: "Women who use Depo Provera may lose significant bone mineral density (BMD)." BMD measures how much calcium is stored in the bones. Using this method over time can result in a calcium loss, but calcium starts to return once this method is stopped.

  • Many women stop using Depo Provera during the first year of use due to irregular bleeding (spotting) and/or prolonged bleeding, which are especially common during the first 3 months of use (see: Depo Bleeding – Will It Ever Stop?).

  • In clinical studies, about 6 percent of women experienced skin reactions in the area where they got their shot. The skin around the injection may get dimpled or feel lumpy.

  • Pfizer recommends that a woman stop her Depo Provera injections one year before she wishes to become pregnant. This is because it takes an average of nine to 10 months (sometimes more than a year) to regain fertility and begin ovulating after receiving the last shot.

  • During the first year of use, most Depo Provera users experience an average weight gain of 3.5 to 5 pounds (see: Will the Depo Provera Shot Cause Weight Gain?).

  • Some women report mild pain associated with the injection.

  • You must remember to schedule your injection appointment every 12 weeks.
Unfortunately, there is no way to stop the side effects that could result from Depo Provera. They may continue until the injection wears off (12 to 14 weeks).

Less Common Side Effects include: change in sex drive, depression, nervousness, dizziness, nausea, change of appetite, headaches, skin rash or spotty darkening of the skin, sore breasts, hair loss and/or increased hair on the face or body

Who Can Use Depo Provera:

This method can be a safe birth control option for most healthy women. It is important that a woman discuss her complete medical history with her doctor before receiving a Depo Provera injection.

Depo Provera is not recommended for women who:

  • Have breast cancer.

  • Are taking medicine for Cushing's syndrome.

  • Have some of the following risk factors for osteoporosis: bone disease, excessive alcohol or smoking, a family history of osteoporosis, anorexia and/or use of steroid drugs.

  • Have unexplained bleeding from the vagina.

  • Adolescent girls –- since this is a critical period for bone mineralization, Depo Provera use should be carefully considered and prescribed only after weighing all other potential options.

  • Will not be able to tolerate irregular bleeding or loss of a period.

  • Want to become pregnant within the next year.
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