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Definition
Depo-Provera is a contraceptive injection for women that contains the hormone progestin. To use Depo-Provera, you'll visit your health care provider for an injection once every three months. Depo-Provera typically suppresses ovulation, keeping your ovaries from releasing an egg. Depo-Provera also thickens cervical mucus to keep sperm from reaching the egg.
Only two injectables — Depo-Provera and Depo-subQ Provera 104 — are approved for contraception by the Food and Drug Administration (FDA) in the U.S. Both contain the hormone progestin, but Depo-subQ Provera 104 contains a lower dose. Depo-Provera is injected deep into the muscle, while Depo-subQ Provera 104 is injected just beneath the skin. Depo-Provera and Depo-subQ Provera 104 have similar benefits and risks, though less long-term information is available on the effectiveness of Depo-subQ Provera 104.
To use Depo-Provera, you'll need a prescription from your health care provider. Depo-Provera doesn't offer protection from sexually transmitted infections (STIs).
Why it's done
Depo-Provera is used for contraception. Among various benefits, Depo-Provera:
- Helps prevent pregnancy
- Eliminates the need to interrupt sex for contraception or seek partner compliance
- Doesn't require a personalized fitting or daily attention
- Decreases the risk of endometrial cancer, pelvic inflammatory disease and uterine fibroids
- Has no adverse effects on breast-feeding (The hormone estrogen, used in many other birth control methods, is known to interfere with milk supply.)
Your health care provider also may recommend Depo-Provera if you have:
- Seizure disorders
- Endometriosis
- Sickle cell disease that seems to be related to your menstrual cycle
- Iron deficiency anemia
- Menstrual pain or prolonged or heavy periods
- Concerns about the side effects of birth control methods containing estrogen
Depo-Provera isn't appropriate for everyone, however. Your health care provider may discourage use of Depo-Provera if you have:
- Unexplained vaginal bleeding
- Breast cancer
- Liver disease
- A history of blood-clotting problems
- Sensitivity to any components of Depo-Provera
In addition, tell your health care provider if you have:
- Osteoporosis risk factors, such as metabolic bone disease, anorexia nervosa or a family history of osteoporosis
- Depression
- A personal or family history of breast cancer
- Breast lumps
- A condition that could be worsened by fluid retention
- Diabetes
- Heart disease
Risks
Side effects of Depo-Provera may include:
- A temporary loss of bone mineral density (The loss increases the longer Depo-Provera is used and may not be completely reversible.)
- Increased risk of bone fracture and osteoporosis
- Irregular periods and breakthrough bleeding
- Weight gain
- Breast soreness
- Headaches
- Depression
- Abdominal pain
- Dizziness
- Fatigue
- Nervousness
- Acne
- Weakness
Depo-Provera doesn't offer protection from sexually transmitted infections (STIs).
An estimated 3 out of 100 women who use Depo-Provera for one year will get pregnant.
It may take 10 months or more for fertility to return after stopping Depo-Provera injections. If you're planning to become pregnant in the next couple of years, consider another form of birth control.
Consult your health care provider as soon as possible if you have:
- Signs of a blood clot in your leg, such as persistent pain in your calf
- Signs of a blood clot in your lung, such as coughing blood, sharp chest pain or sudden shortness of breath
- Signs of a stroke, such as a sudden severe headache, problems with vision or speech, or numbness in an arm or leg
- Signs of a blood clot in your eye, such as sudden partial or complete blindness
- Other eye problems, such as double vision
- Signs of jaundice, such as yellowing of the skin or whites of the eyes
- A sudden onset of migraines
- Severe lower abdominal pain
- Depression
- A serious allergic reaction
- Heavy bleeding or concerns about your patterns of bleeding
- Pus, prolonged pain, redness, itching or bleeding at the injection site
Use of progestins is associated with a risk of blood clots and heart attacks. However, estrogen has been shown to promote blood clots when given alone, and most contraceptive methods contain both estrogen and progestin. Many experts believe progestin-only contraceptive methods carry significantly lower risks of these types of complications than do contraceptive methods that contain both estrogen and progestin.
How you prepare
You'll need to request a prescription for Depo-Provera from your health care provider. He or she will review your medical history and check your blood pressure. Talk to your health care provider about any medications you're taking, including nonprescription and herbal products. If you're interested in giving yourself Depo-Provera injections at home, ask your health care provider if self-administration is an option.
What you can expect
To use Depo-Provera:
- Consult your health care provider about a starting date. To make sure you're not pregnant when you're injected with Depo-Provera, your health care provider will do your first injection within five days of the start of your period. If you've just given birth and you're not breast-feeding, your first injection will be done within five days of giving birth. If you're breast-feeding, your first injection will be done six weeks after you give birth.
- Prepare for your injection. Your health care provider will clean the injection site — either the shoulder or buttocks for Depo-Provera or the abdomen or upper thigh for Depo-subQ Provera 104 — with an alcohol pad. After the injection, don't massage the injection site. Use a backup method of birth control for seven days after your first injection. Backup birth control isn't necessary after subsequent injections.
- Schedule your next injection. Depo-Provera injections must be given every 12 weeks. If you wait longer than 13 weeks between injections, you may need to take a pregnancy test before your next injection to verify that you aren't pregnant.
Last Updated: 2010-01-06
