Depo-Provera (birth control shot)

Overview

Depo-Provera is a well-known brand name for medroxyprogesterone acetate. It's a birth control shot that has the hormone progestin. A birth control shot is also called a contraceptive injection. People who take Depo-Provera get a shot every three months.

Depo-Provera most often stops the ovaries from releasing an egg. So there's no ovulation. Depo-Provera also thickens mucus in the lower end of the uterus, called the cervix, to keep sperm from reaching the egg. And it thins the lining of the uterus.

Medroxyprogesterone acetate also comes in a lower dosage. This version is called Depo-SubQ Provera 104. While Depo-Provera goes deep into the muscle, Depo-SubQ Provera 104 goes just beneath the skin.

Both Depo-Provera and Depo-SubQ Provera 104 are alike in how they work and in their risks. To use Depo-Provera or Depo-SubQ Provera 104, you need to see a healthcare professional.

Why it's done

Depo-Provera is used to prevent pregnancy and manage medical conditions linked to the menstrual cycle. A healthcare professional might suggest Depo-Provera if:

• You don't want to take a birth control pill every day.
• You can't or don't want to use estrogen.
• You have health problems such as anemia, seizures, sickle cell disease, endometriosis or uterine fibroids.

Among the pluses, Depo-Provera:

• Doesn't need daily action.
• Gets rid of the need to stop sex for birth control.
• Lessens menstrual cramps and pain.
• Lessens menstrual blood flow and sometimes stops periods.
• Lowers the risk of uterine and endometrial cancer.

But Depo-Provera isn't for everyone. You might not want to use Depo-Provera if you have:

• Vaginal bleeding with no known cause.
• Breast cancer.
• Liver disease.
• Reactions to any part of Depo-Provera.
• Risk factors for the bone-thinning condition called osteoporosis.
• A history of heart attack or stroke.

Also, tell your healthcare professional if you have diabetes, uncontrolled high blood pressure, a history of heart disease or stroke, or a history of vaginal bleeding with no known cause.

Risks

In a year of typical use, about 6 out of 100 people will get pregnant in the first year of using Depo-Provera. But the risk of pregnancy is much lower for people who get the shot every three months.

Studies show that both types of Depo-Provera work well. People who give themselves the shots may use the birth control longer than those who get the shots from a healthcare professional.

Among the things to think about with Depo-Provera are:

• You might have a delay in being able to get pregnant, called fertility, when you want to. After stopping Depo-Provera, it might take 10 months or more before you begin ovulating again. If you want to become pregnant in the next year or so, Depo-Provera might not be the right birth control method for you.

• Depo-Provera doesn't protect against sexually transmitted infections. In fact, some studies suggest that hormonal birth control such as Depo-Provera might raise the risk of chlamydia and HIV. It isn't known whether this link is due to the hormone or the behavior of people who use Depo-Provera.

  Condoms lower the risk of a sexually transmitted infection. If you're worried about HIV, talk with your healthcare professional.

• It might affect the bones. Research has suggested that Depo-Provera and Depo-SubQ Provera 104 might cause bones to weaken. But once you stop the shots, some or all the lost bone may come back. And the bone loss is not likely to increase the risk of broken bones.

  But the U.S. Food and Drug Administration has strong warnings on Depo-Provera and Depo-SubQ Provera 104 packages. The warning states that these medicines shouldn't be used for longer than two years. The warning also says that these products might raise the risk of the bone-thinning condition osteoporosis. It's not known if using these products raises the risk of broken bones later in life.

  If you have other risk factors for osteoporosis, talk with your healthcare professional about whether this form of birth control is a good choice for you. Ask about other birth control choices. Risk factors for osteoporosis include a family history of the condition and some eating disorders.

Other side effects of Depo-Provera most often ease or stop within the first few months. They might include:

• Belly pain.
• Bloating.
• Less interest in sex.
• Depression.
• Dizziness.
• Headaches.
• Irregular periods and breakthrough bleeding.
• Nervousness.
• Weakness and tiredness.
• Weight gain.

Contact your healthcare professional as soon as possible if you have:

• Mood change.
• Heavy bleeding or worries about your bleeding.
• Trouble breathing.
• Pus, prolonged pain, redness, itching or bleeding at the site of the shot.
• Bad lower belly pain.
• A serious allergic reaction.
• Other symptoms that worry you.

How you prepare

You need a prescription for Depo-Provera. Your healthcare professional reviews your medical history and may check your blood pressure before prescribing the medicine.

Talk to your healthcare professional about all your medicines. Include medicines you take without a prescription and herbal products. If you want to give yourself Depo-Provera shots at home, ask your healthcare professional about that choice.

What you can expect

To use Depo-Provera:

• Talk with your healthcare professional about a starting date. You need to be sure that you're not pregnant when you get Depo-Provera. So your first shot should be within seven days of the start of your period. If you don't get it then, use backup birth control, such as condoms, for two weeks.

  If you've just given birth, you'll get your first shot within five days of giving birth, even if you're breastfeeding. If you start Depo-Provera at other times, you might need to take a pregnancy test first.

• Prepare for your shot. A member of your healthcare team first cleans the area where you get the shot with an alcohol pad. After the shot, don't rub the site.

  Depending on your start date, your healthcare team might suggest that you use a backup method of birth control for seven days after your first shot. You won't need backup birth control after your other shots if you get them on schedule.

• Schedule your next shot. You need to get Depo-Provera shots every three months or every 13 weeks. If you wait longer than 15 weeks between shots, you might need to take a pregnancy test before your next shot and use a backup method of birth control for seven days after the shot.