What It Is

Depo-Provera is a hormonal contraceptive that is administered through an injection every 12 weeks. Its effectiveness rate is 99.7 percent. For women who don't want to have to remember to take a pill every day and who find barrier methods, such as the condom and diaphragm either messy or not spontaneous enough, Depo-Provera may be a good choice. Because Depo-Provera does not contain estrogen, it is a safe option for women who are breastfeeding, and those who, for medical reasons, cannot use the combination pill or the patch.

How It Works

Depo-Provera contains medroxyprogesterone acetate, a drug very similar to progesterone, which is a hormone produced by the ovaries every month as part of the menstrual cycle. Depo-Provera works to prevent pregnancy by preventing the release of an egg from the ovary. It can also thicken the cervical mucus, which blocks sperm from reaching an egg, and thins the endometrial lining of the uterus, which can make it more difficult for a fertilized egg to attach to the uterus.

Advantages

• Highly effective
• Lasts for 12 weeks
• Does not require taking pills each day
• Does not interfere with spontaneity during sex
• Can be used by women who cannot take estrogen
• Can be used by women who are breastfeeding

Disadvantages

• Must be administered by a health-care professional
• Requires a visit to a clinic or doctor's office every three months for a shot
• Does not protect against HIV or other sexually transmitted infections.
• May take up to one year to become fertile following the last shot
• Long-term use may decrease bone density.

Who Should Not Use Depo-Provera

You should not use Depo-Provera if you:

• are pregnant or might be pregnant
• have liver disease
• have a history of blood clots or stroke
• have unexplained vaginal bleeding
• have breast cancer
• have cancer of the reproductive organs

Health Benefits

Possible Side Effects

It is common to experience irregular menstrual bleeding while using Depo-Provera. You may bleed for several days at a time. It's also possible that you'll bleed for several days, stop, and then bleed again. Some women may bleed for two to three weeks at a time. Over time, the bleeding usually gets lighter and stops altogether, which is normal and not harmful.

Other, possible side effects include weight gain, headache, breast tenderness, and depression. 

Health Risks

Depo-Provera is not a good option for women who plan to become pregnant in the near future, since it can take up to a year before you become fertile again. Depo-Provera may also decrease HDL cholesterol, the good kind of cholesterol that protects against heart disease. In addition, it may speed up the growth of undetected cancers and decrease bone density. Before using Depo-Provera, be sure to ask your health care provider about any medical conditions that might exclude you from using this type of hormonal contraception.

How to Use Depo-Provera

A nurse practitioner or clinician must inject Depo-Provera.  The injection is given within the first five days of the menstrual cycle, when you are not pregnant and not ovulating. If the injection is given after the first five days of your menstrual cycle, you should use a backup method of birth control such as a male condom, female condom, or diaphragm, for the first seven days. Every 12 weeks, you need to get another injection.

When to see a doctor

If you experience any of the following problems, while on Depo-Provera, call a doctor immediately:

• Unusual pain or swelling in the arms or legs
• Sharp chest pain
• Coughing up blood
• Shortness of breath
• Sudden severe headaches
• Vision changes (blurring, doubling, loss of vision)
• Fainting or dizziness
• Severe stomach or abdominal pain
• Jaundice (yellowing of skin or eyes)
• Severe depression
• Heavy, prolonged vaginal bleeding
• Drug interactions
• Drug interaction: Keep in mind that Depo-Provera is a medication. Like all drugs, it can interact with other substances, including drugs such as tetracycline; Dilantin; and St. John's wort, an herbal supplement used to treat depression. Several other drugs also should not be taken with Depo-Provera. Be sure to discuss any medications you are currently taking with your health care provider.

How to Protect Against STIs and HIV/AIDS

The only way to guard against getting sexually transmitted infections (STIs) is not to have sex or to have sex only with partners who you know are free of infection. If you do have sex, you should use a latex barrier, such as a male condom, a female condom, or a dental dam, every time. Condoms provide protection against against some STIs, including HIV, the virus that causes AIDS. Tapestry Health clinicians recommend using such barriers even in combination with other methods of birth control . Latex condoms are preferred to lambskin condoms for the prevention of STIs. Using a spermicide together with a latex barrier can also help keep you from getting an STI.

If you have any questions about Depo-Provera, talk to your clinician.