Depo-Provera

Depo-Provera, sometimes called the Depo shot or birth control shot, contains medroxyprogesterone acetate and uses the hormone progestin to prevent ovulation. This prevents pregnancy because sperm can’t reach the egg.

In more scientific terms, clinical pharmacist Dazhi Liu explains, “When used as an injection for contraception (doses of 150 mg IM or 104 mg SubQ), medroxyprogesterone acetate inhibits secretion of pituitary gonadotropins, which prevents follicular maturation and ovulation and causes endometrial thinning.”

Medical providers inject Depo-Provera 150 mg into muscle in the arm or buttocks. The shot is effective for about three months.

A second formula, DepoSubQ-Provera 104 mg, is FDA-approved to prevent pregnancy and pain from endometriosis, and it’s injected into the abdomen or upper thigh. When the shot is used as a treatment for endometrial pain, it suppresses new growth of endometrial tissue. Patients may be taught to self-administer DepoSubQ at home, even if the prescribing label doesn’t recommend it.

Dosage and Administration

Depo-Provera and DepoSubQ-Provera are birth control shots administered by health care providers. In some cases, DepoSubQ-Provera can be self-administered by patients. The following are guidelines from the drugs’ prescription information label.

It’s important to follow the instructions of your health care provider when it comes to dosage and administration. If you have any questions, make sure to contact your provider before starting or stopping a medication.

Depo-Provera is about 96% effective at preventing pregnancy. Generally, the less a person must do to be compliant with doing schedules, the more effective hormonal birth control is.

In the case of Depo-Provera, missing a shot or not getting a shot on time are the biggest reasons why it may fail. IUDs and birth control implants are considered the most effective forms of birth control.

Is Depo-Provera Different from Other Types of Birth Control?

Depo-Provera is different from other types of birth control because it is a birth control shot you receive from your medical provider. Unlike most other types of oral birth control options, you don’t need to take it every day. Instead, you get one shot every three months.

The most important thing is to make sure you keep a regular shot schedule with your provider to prevent pregnancy. For some women, this may be more convenient than taking a pill every day.

However, it’s not recommended for long-term use of more than two years for preventing pregnancy or endometriosis pain unless there are no other options.

In clinical trials, the most common Depo-Provera side effects occurred in more than 5% of test subjects. Pfizer used trial data from two clinical trials with over 3,000 women treated for up to seven years.

Serious side effects are rarer, but some of them — such as allergic reactions — are medical emergencies.

Common Side Effects

Common Depo-Provera side effects typically subside within two to three months after the body gets used to the hormone changes. Each person is different, and some side effects may go away more quickly or last longer than others.

Some of these side effects led people to discontinue the trial, and these were bleeding, amenorrhea and weight gain.

Serious Side Effects

Serious side effects listed on Depo-Provera’s prescription label include bone density loss, increased risk of breast cancer and allergic reactions. Depo-Provera and DepoSubQ-Provera have black box warnings for loss of bone mineral density. A black box warning is the FDA’s strongest warning.

Make sure you tell your medical provider about any side effects you experience. Depending on the severity of the side effects, your provider may switch you to another method of birth control.

Depo-Provera Brain Tumor Risk

A recent March 2024 study published in BMJ found that Depo-Provera may be linked to a higher risk of developing a type of noncancerous brain tumor called meningioma. According to researchers, Depo-Provera users had a 5.6-fold increase in the risk of developing meningioma. It’s important to note that the risk was seen with long-term use.

Since this was an observational study, there isn’t enough data to confirm Depo-Provera causes meningioma. This study is the first of its kind and more studies are needed to better understand the risk.

However, because of these findings, lawyers are currently investigating Depo-Provera lawsuits for users who took the brand name and generic version of the birth control shot.

If you are concerned about any of these serious side effects, make sure to discuss your risk with your doctor.

Depo-Provera and DepoSubQ-Provera aren’t for everyone, and if you have certain pre existing medical conditions, you shouldn’t use the birth control shot.

Make sure to discuss your medical history and risks with your doctor before taking Depo-Provera or DepoSubQ-Provera.

Depo-Provera Alternatives

If Depo-Provera isn’t right for you, your medical provider can discuss alternatives with you, including oral contraceptives, an IUD or an implant. Some people may be searching for an alternative because of the potential risk for meningioma.

“The [BMJ] study showed prolonged use of medrogestone, medroxyprogesterone acetate, and promegestone was found to be associated with an increased risk of meningioma. No excess risk of meningioma was associated with the use of progesterone, dydrogesterone, or spironolactone, or the hormonal intrauterine systems used worldwide, regardless of the dose of levonorgestrel they contained,” according to Liu.

Liu added that Depo-Provera alternatives will vary depending on why a patient was taking the birth control shot, such as preventing pregnancy or treating endometrial pain.