Depo-Provera, the birth control shot, is a long-acting progestin (hormone) method of birth control. It is injected every 3 months. It is effective 24 hours after your first injection if given in the first 5 days of a normal menstrual period, otherwise it takes about a week to go into effect. During the first 7 days after receiving the shot for the first time, it is recommended that you use a backup method such as condom use or abstinence. You will need to receive your injection promptly every 12-13 weeks in order to continue your contraceptive protection. It is possible to receive your depo shot every 11 weeks to limit any breakthrough bleeding when due for your next shot.
What is Depo-Provera?
How does it work to prevent pregnancy?
Depo Provera 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.
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 or delayed.
Depo-Provera does not offer any protection against sexually transmitted infections (STIs). We recommend using condoms along 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. Depo Provera can be taken along with these medications.
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 people who cannot take estrogen, including people who are breastfeeding.
What are some reasons NOT to use it?
People who use the birth control shot may have 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.
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. This means you will have to live with any side effects until the medicine wears off in 3 months.
Bleeding, spotting and amenorrhea (not having periods) are common. After a year of Depo-Provera injections, 57% of users are not menstruating. After 2 years, 68% are not menstruating. If you stop getting Depo-Provera injections, your period usually returns within 3 to 10 months.
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 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 may occur but the cause is unclear. It does go away if you stop using Depo-Provera.
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.
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% 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.
There is no increased risk of ovarian, uterine, cervical or liver cancer. While Depo Provera has not been linked to an overall increase in risk for breast cancer, one study found a slightly increased risk of breast cancer for current, longer term users when compared to people who had never used Depo-Provera.
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.
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
Where can I get Depo-Provera and how much does it cost?
Depo-Provera is available at Health Services and costs $61.75 for each shot (3 months of contraceptive coverage). 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.