6 Common Depo Provera Side Effects

Symptoms range from mild and transient to intolerable

Depo-Provera is an injectable form of hormonal birth control which uses progestin (a synthetic form of progesterone) to prevent pregnancy. Depo-Provera is not only discreet and convenient, it is as much as 99.7 percent effective when used correctly. As a ​progestin-only contraceptive, it may be a great choice if you are unable to use estrogen-based contraception.

Depo-Provera side effects may occur as your body adjusts to the effects of the medication. Some are women affected more than others, and some may not experience any symptoms at all. The most common side effect of Depo-Provera (occurring in over five percent of women) include:

1
Irregular Menstrual Bleeding

Depo Provera Side Effects
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Many women stop using Depo Provera during the first year of use due to prolonged spotting or bleeding. These side effects are especially common during the first three months but can persist in some women for more than a year.

Sadly, there is no way to predict who will experience bleeding or how severe the symptoms may be. In some cases, termination of treatment is the only option.

For others, estrogen supplementation, Lysteda (tranexamic acid), and Ponstel (mefenamic acid) may provide short-term relief until the body better normalizes to effects of the drug.

2
Termination of Periods

Pantyliner, packed sanitary pad and tampon, close up
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After a few shots, Depo Provera will usually stop menstruation. When this happens, it may either make your periods very light or terminate them altogether.

Clinical studies estimate that over a third of women on Depo Provera will experience amenorrhea by month six. After a year, that number will increase to 55 percent and continue increase to 68 percent by year two.

Many women, in fact, are willing to tolerate the initial bleeding in exchange for the chance of not having to have a period anymore.

3
Bone Density Loss

Skeletal X-Ray Shoulder
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Depo Provera contains a black box warning about the possibility of progressive bone loss. According to the manufacturer, if Depo Provera is used continuously for more than two years, the loss of calcium may significantly increase the risk of osteoporosis and broken bones.

Because of this, it is recommended that women should limit their use to no more than two years. To mitigate bone loss, doctors will often recommend calcium and Vitamin D supplements along with a calcium-rich diet.

It is important to remember that if bone loss occurs, it is considered permanent and will not return.

4
Weight Gain

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Weight gain another common reason why women will stop using Depo Provera.

According to research from the University of Texas Medical Branch in Galveston, around two-thirds of women who used Depo Provera reported a weight gain of five pounds during the first year. That number increased to eight pounds by year two and continued to increase, year on year, by an additional four pounds.

By year six, women on Depo Provera gain an average of 16.5 pounds (or roughly 2.75 per year).

This effect, however, is not seen in all women. Regular exercise and a calorie- and fat-restricted diet can often mitigate the risk.

5
Delayed Return of Fertility

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Depo Provera has a prolonged contraceptive effect. Once stopped, it may take up to a year to regain fertility and start ovulating normally again.  If you decide to get pregnant, you would likely have to wait for at least nine to 10 months before trying.

According to post-market research from the manufacturer, it took 68 percent of women 12 months to get pregnant after stopping Depo Provera. By 15 months, the overall figure increased to 83 percent. By 18 months, a total of 93 percent of women who wanted to get pregnant were able to do so.

6
Local Injection Reactions

Woman getting a shot.
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One of the more common, and perhaps least worrisome, symptoms of Depo Provera are local reactions to the shot. Some women will report mild pain associated with the injection, while six percent will experience skin reactions around the area where the shot was delivered. Both tend to be relatively minor and will resolve on their own within a day or two.

Other common systemic side effects include:

  • Abdominal pain or discomfort
  • Dizziness
  • Headache
  • Weakness or fatigue
  • Nervousness

For the most part, these types of symptoms improve the longer you take Depo Provera and usually don't need treatment.

Sources:

Grossman Barr, N. "Managing Adverse Effects of Hormonal Contraceptives." Am Fam Physician. 2010; 82(12):1499-1506.

Spevak, E. "The Long-term Health Implications of Depo-Provera." Integrative Medicine. 2013; 12(1): 27-34.

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