Depo Provera: Advantages vs. Disadvantages

Pros, Cons, Health Benefits and Side Effects

Depo Provera. Photo © 2014 Dawn Stacey

Depo Provera is an injectable progestin-only contraceptive that prevents pregnancy for up to 3 months with each shot. It is available in two formulations:

  • Depo Provera Injection: each shot contains 150 mg of the progestin, medroxyprogesterone acetate. The Depo Provera shot must be injected into a muscle every 11 to 13 weeks.
  • Depo-subQ Provera 104 Injection: each shot contains 104 mg of medroxyprogesterone acetate. This newer shot has to be injected under the skin every 12 to 14 weeks.

    Depo Provera Advantages:

    • The birth control shot is a great alternative for if you don't want the hassle of using a daily birth control method, like the Pilll.
    • You only have to get Depo Provera injections 4 times a year (so once you get your Depo shot, you don't need to think about birth control for months).
    • Depo Provera may make your periods very light, and periods may stop altogether after a few Depo injections.
    • It is a highly effective and reversible prescription birth control option.
    • Depo Provera does not interfere with having sex, so it allows for sexual spontaneity.
    • Is a private and discreet contraceptive choice (nobody has to know that you use Depo Provera -- there are no wrappers or pill compacts).
    • Depo does not contain estrogen, so it can be a good alternative if you who cannot tolerate estrogen or use combination contraceptives.
    • Women who are breastfeeding or are 6-weeks postpartum can safely use Depo Provera.

      Non-Contraceptive Advantages of Depo Provera:

      The Depo-subQ Provera 104 injection is the first new remedy in the last 15 years that has been FDA-approved for the treatment of endometriosis-related pain. Research shows that Depo-subQ Provera 104 treats endometriosis pain as effectively as leuprolide, but it is associated with fewer vasomotor symptoms (like hot flashes or sweats) and significantly less bone loss.

      In fact, Depo Provera offers pain relief statistically equivalent to that of leuprolide across all endometriosis-associated areas -- pelvic pain, pelvic tenderness, dysmenorrhea, painful intercourse, and hardening and thickening of tissue.

      After a few injections, Depo Provera usually stops menstruation, resulting in thinner, more compact endometrial tissue. This, in turn, can stop the growth of endometrial implants, relieving endometriosis-related pain.

      Depo Provera can also help to prevent cancer of the lining of the uterus. It appears that Depo Provera use can lower your risk of endometrial/uterine cancer by approximately 80%. This protective effect of the Depo shot seems to last for at least 8 years once you stop using Depo Provera.

      Depo Provera Disadvantages:

      • The package insert of Depo Provera contains a black box warning about possible bone loss: "Women who use Depo Provera may lose significant bone mineral density (BMD)." BMD measures how much calcium is stored in the bones. Using the repo shot over time can result in a calcium loss, but calcium starts to return once this method is stopped. Because of this warning, Depo Provera may not be the best contraceptive option for adolescent girls.
      • Many women stop using Depo Provera during the first year of use due to spotting/irregular bleeding and/or continuous bleeding. This side effect is especially common during the first 3 months of Depo use. Unfortunately, there is no way to know ahead of time whether or not you will experience these bleeding issues.
      • In clinical studies, about 6% of women experienced skin reactions in the area where they got their Depo shot. The skin around the injection may also get dimpled or feel lumpy.
      • Pfizer, the manufacturer of Depo Provers, recommends that you stop your Depo injections one year before you would like to become pregnant. This is because it takes an average of nine to 10 months (and sometimes even a year or longer) to regain fertility and begin ovulating after receiving your the last shot.
      • During the first year of use, Depo Provera users typically experience an average weight gain of 3.5 to 5 pounds.
      • Some women report mild pain associated with the Depo injection.
      • You must remember to schedule your injection appointment every 12 weeks. If its been more than 13 weeks since your last Depo shot (or 14 weeks since your last Depo-subQ 104 shot), make sure to use a back-up birth control method because you could be at risk for getting pregnant.
      • Due to the possibility of bone density loss, it is also recommended that you shouldn't use Depo Provera or Depo-subQ Provera 104 for more than two years.

      Unfortunately, there is no way to stop the side effects that can result from Depo Provera use. There is the chance that these side effects may continue until your Depo injection wears off (12 to 14 weeks).

      Less Common Depo Provera Side Effects include: change in sex drive, depression, nervousness, dizziness, nausea, change of appetite, headaches, skin rash or spotty darkening of the skin, sore breasts, hair loss and/or increased hair on the face or body.

      Additional Depo Provera Considerations:

      Depo Provera is a highly effective birth control method. If you get your first Depo shot within the first 5 days of your period, Depo Provera provides immediate pregnancy protection, so you will not need to use a back-up method. If you get your first shot during any other time in your cycle, you should use a back-up method, like condoms, for at least the next 7 days.

      You can easily switch from Depo Provera to Depo-subQ Provera 104 at your next scheduled injection time; if you do this, you will have immediate pregnancy protection.

      If you are currently using another hormonal method and decide to switch to Depo Provera, you should receive your first Depo shot within 7 days after the last day of using your current method. So:

      • If switching from combination birth control pills, you should have your first Depo shot within 7 days after taking your last active pill.
      • If switching from the Ortho Evra Patch, plan to get your Depo Provera injection within 7 days after removing your patch.
      • If switching from the NuvaRing, schedule your first Depo shot within 7 days after taking the ring out.


      Kaunitz AM. "Current options for injectable contraception in the United States." Semin Reprod Med. 2001; 19(4):331–337. Accessed via private subscription.

      Nezworski L, Murray S. "Use of depot medroxyprogesterone acetate in current gynecologic practice." Postgraduate Obstetrics & Gynecology. 15 April 2010; 30(7):1–6. Accessed via private subscription.

      Schlaff WD, Carson SA, Luciano A, Ross D, Bergqvist A. "Subcutaneous injection of depot medroxyprogesterone acetate compared with leuprolide acetate in the treatment of endometriosis-associated pain." Fertility and Sterility. 2006; 85(2): 314-325. Accessed via private subscription.

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