Before You Have Your First Depo-Provera Shot

Depo-Provera Black Box Warning

Depo Black Box Warning
Depo Black Box Warning. Photo © 2015 Dawn Stacey

Depo-Provera is a reversible, prescription birth control method. The Depo-Provera shot releases the synthetic form of progestin medroxyprogesterone acetate that can protect against pregnancy for a period of 11 to 14 weeks. This method prevents ovulation, and also works by thickening cervical mucus, which makes it harder for sperm to swim through. Additionally, the progestin in Depo-Provera can thin out the uterine tissue or can even prevent this lining from occurring.

This makes it difficult for a fertilized egg to implant into the uterine wall since there is not enough lining there to receive it.

Safety Warning:

The package inserts for both Depo-Provera and Depo-subQ Provera 104 contain a mandated black box warning concerning possible bone loss while using this birth control method.

    The Depo Provera Black Box Warning Reads:

    • “Use of Depo-subQ Provera 104 or Depo-Provera may cause you to lose calcium stored in your bones. The longer you use Depo-Provera, the more calcium you are likely to lose. The calcium may not return completely once you stop using Depo-Provera. Loss of calcium may cause weak bones that could increase the risk that your bones might break, especially after menopause. It is not known whether your risk of developing osteoporosis may be greater if you are a teenager when you start to use Depo PDepo-Provera should only use Depo-Provera long term (more than 2 years) if other methods of birth control are not right for you”.

        What This Warning Means:

        Women who use Depo-Provera may lose significant bone mineral density (BMD). BMD is a measure of how much calcium is stored in your bones. Bone loss is greater with increasing duration of Depo-Provera use and may not be completely reversible. Calcium loss may cause weak, porous bones (osteoporosis) that could increase the chances of bones fracture, especially after menopause.

          Depo-Provera Use:

          It is important that you discuss the risks and benefits of this method of birth control with your doctor as well as your overall bone health and risk factors for osteoporosis. It is recommended that most women use Depo-Provera or Depo-subQ Provera 104 for no more than two years. A woman should continue with this method (for more than 2 years) only after weighing all other potential options, and it is determined that no other birth control methods are right for her.

            The Importance to Maintain a Healthy Lifestyle:

            While using Depo-Provera, a woman should try to incorporate a healthy lifestyle as this can help maintain bone health. According to Pfizer (manufacturer of Depo-Provera), a diet containing lots of vegetables, plus calcium supplements and vitamin D, can also be helpful. Regular weight-bearing exercise, such as running, hiking, and walking, can also help keep your bones in good shape. Talk to your health-care provider about a diet and exercise plan that may be right for you.


            Pfizer. (2005). “Depo-SubQ Provera 104” and (2004). “Depo Provera: Contraceptive Injection”.

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