Depo-Provera Alternatives

Choosing the right birth control method is a deeply personal decision, and while Depo-Provera is effective, it might not be the best choice for everyone. If you’ve noticed side effects such as changes in weight, mood swings or problems with bone health, you might want to look into other options. Additionally, using Depo-Provera long-term could lead to other health issues, including a higher risk of certain types of tumors.

When considering birth control, it’s important to weigh the advantages and disadvantages of each option. Think about whether you want something that you can control daily, like the pill or patch, or a longer-lasting option, like an IUD or implant, which doesn’t require as much regular attention. Taking into account your health history, lifestyle, and future plans can help you make the best choice for yourself.

The Depo-Provera shot can be a convenient birth control option, but it’s only recommended for up to two years of continuous use for most patients. Not everyone is a good candidate for Depo-Provera, and side effects may cause some people to seek other options like the birth control pill, patch or IUD.

There are several reasons you may want to look for an alternate form of birth control.

You Plan to Get Pregnant in the Next Year or Two

Some people might be able to get pregnant within 12 to 14 weeks of their last Depo-Provera shot, while others may take up to two years to conceive. If you’re looking to have a baby within the next few years, a short-term form of birth control may be a better fit.

You Are Concerned About Health Risks Associated With Depo-Provera

A 2024 study in The British Medical Journal found that long-term use of Depo-Provera may increase the risk of meningiomas, a type of tumor often formed in the tissue lining the brain, by over five times.

Long-term use of Depo-Provera could also lead to bone density loss, which can be detrimental as you age. This is especially true for younger women and teens.

You Have a History of Breast or Reproductive Cancer

Depo-Provera has been linked to an increased risk of breast and cervical cancer. If you or a family member have experienced these types of cancers, a different form of contraceptive may be a safer option.

You Experienced Severe Side Effects or Have Certain Health Conditions

A loss of bone mineral density, severe allergic reaction or blood clots are all examples of serious Depo-Provera side effects that may require a different form of birth control. There are several health risks to consider, according to Depo-Provera’s label.

Clinical trials have also found several common side effects among 5% or more of people taking Depo-Provera.

You Have Certain Pre-Existing Conditions

Taking Depo-Provera may be riskier for people with some medical conditions as it can increase the chances of complications.

You Have Had a Blood Clot in Your Legs, Arms or Lungs

Depo-Provera and other hormonal birth control options may increase your risk of blood clots, so your doctor may recommend a different form of contraception if you’ve had a blood clot in the past.

You Need a Birth Control Option for More Than 2 Years

The FDA warns that Depo-Provera should only be used for two years. Chat with your doctor if you’d like a birth control option that you can take for a longer period of time.

You Are Looking for Acne Treatment

While some forms of birth control may improve acne, Depo-Provera may cause additional breakouts as a side effect.

Talk to your doctor about your medical history before starting any form of birth control. Addressing specific questions or concerns can help you find the right method for you and help you decide if you should look for an alternative to Depo-Provera.

When it comes to choosing the best birth control for you, it’s important to think about your health, daily routine and plans for the future.

Some methods use hormones, while others don’t. Some birth control lasts for a short time, while others can last for months or years. Your doctor can help you find an option that fits your health needs and personal preferences.

Depo-Provera is a short-acting hormonal birth control method requiring an injection from your health care provider every 12 weeks to be effective, making it one of the most reliable forms of contraception available.

• Effectiveness: 99% effective when used as recommended, 94% effective if you miss your shots.
• Side effects: Bleeding, weight gain, headaches, nervousness.
• Risks: Blood clots, Ectopic pregnancy, anaphylaxis, jaundice or liver problems. Some studies have linked Depo-Provera use to meningioma tumors.

Short-acting hormonal birth control works by releasing hormones that stop the ovaries from releasing eggs. They can also help keep sperm from reaching and fertilizing an egg. They are short-acting methods since you have to use them daily, weekly or monthly.

Typically, short-term birth control methods are a good choice if you are planning to become pregnant soon. You can usually stop taking them easily and your fertility quickly returns.

Combination Birth Control Pills vs. Depo-Provera

Combination birth control pills contain both progestin and estrogen, while Depo-Provera contains progestin only.

Both methods are highly effective if taken exactly as recommended. However, pills are slightly less effective if you miss taking them on time.

• Effectiveness: 99% effective if taken as prescribed, 91% if not used regularly.
• Side effects: Breast tenderness, headaches, irregular periods, nausea, vomiting and weight gain are among the most common.
• Risks: Increased risk of blood clots and depression.

Progestin-Only Pills vs. Depo-Provera

Progestin-only birth control pills — also called minipills — work by thickening the cervical mucus and thinning the uterine lining, both of which help to prevent pregnancy.

It may be a good option for people who are breastfeeding, have high blood pressure, have a history of blood clots, or those who can’t take estrogen because of various medical conditions.

• Effectiveness: 99% effective if used daily as prescribed, 91% effective if not used correctly.
• Side effects: Acne, breast tenderness, headaches, increased hair growth, nausea, unpredictable bleeding and weight gain.
• Risks: Smoking or other tobacco use while taking the minipill can increase your risk of heart attack and stroke.

Xulane Transdermal Patch vs. Depo-Provera

Like Depo-Provera, Xulane (norelgestromin/ethinyl estradiol) is a hormonal birth control option. You stick the patch on your skin, typically on your upper arm, back, buttocks or upper torso. You leave the patch in place until you replace it weekly. After three weeks, you don’t use a patch for a week. Then, you repeat the process.

• Effectiveness: 99% effective if used as prescribed, but only 94% if not used as instructed.
• Side effects: Headache, irregular bleeding, mood changes, nausea and sore breasts.
• Risks: Increased risks of blood clotting, heart attack, high blood pressure, gallbladder disease, liver cancer and stroke.

Serious health risks increase for those over 35 who smoke, have uncontrolled high blood pressure or diabetes, or a history of blood clots, heart attacks or strokes. Be cautious if you experience migraines with visual disturbances or unusual bleeding. Some medications can also affect the patch’s effectiveness, so talk to your doctor about your personal risks from the patch.

NuvaRing vs. Depo-Provera

NuvaRing is a vaginal ring that uses etonogestrel and ethinyl estradiol. It’s a small, flexible ring that you insert into your vagina. You wear it for three weeks, then take it out for a week. It contains hormones that help prevent pregnancy.

Both NuvaRing and Depo-Provera help prevent ovulation and make it harder for sperm to reach the egg. However, they can cause different side effects. Some people using NuvaRing might experience nausea, spotting between periods, tenderness in their breasts or irritation.

• Effectiveness: 99% if used as prescribed, 91% if not used correctly.
• Side effects: Breast tenderness, weight gain, headaches, nausea, vomiting, decreased sex drive, vaginal discharge.
• Risks: Heart attack, stroke, blood clots, high blood pressure, toxic shock syndrome, gallbladder disease.

Long-acting reversible contraceptives are effective and convenient birth control options that can last three to 12 years. These methods don’t require you to do anything daily, weekly or monthly, making them promising alternatives to Depo-Provera.

The two main types are implants and intrauterine devices, which are more than 99% effective, according to a patient article published in the JAMA Network. They are safe to use while breastfeeding, and you can have them removed whenever you want.

Once removed, your ability to get pregnant typically returns right away.

Copper IUD Paragard vs. Depo-Provera Alternative

Paragard is a small, T-shaped device made of copper placed in the uterus. It can prevent pregnancy for up to 10 years without using hormones. Once removed, you could get pregnant right away. However, it might make your periods heavier and increase cramping.

• Effectiveness: Greater than 99%.
• Side effects: Heavy, longer, more painful or irregular periods and spotting between periods.
• Risks: Lawsuits claim that Paragard IUDs may break upon removal, causing injuries and sometimes requiring surgery to remove.

Hormonal IUDs vs. Depo-Provera

Hormonal IUDs like Mirena, Skyla, Liletta and Kyleena utilize the hormone progestin to prevent pregnancy. Progestin IUDs are small devices inserted into the uterus that can work for three to seven years, depending on which one you use. They don’t require regular maintenance and can lighten or stop your periods. Plus, you can get pregnant right away after having them removed.

Like Depo-Provera, hormonal IUDs are estrogen free, making them safe for people who need to avoid certain hormonal risks.

• Effectiveness: More than 99% effective.
• Side effects: Breast tenderness, discomfort, heavier periods, irregular bleeding, mood changes and spotting between periods.
• Risks: IUD falling out, the device puncturing the uterine wall and infection among people with undiagnosed sexually transmitted diseases.

You should not get an IUD if you have a sexually transmitted infection (STI), pelvic infection, unexplained vaginal bleeding or a history of uterine or cervical cancer.

Nexplanon Implanted Birth Control vs. Depo-Provera

Nexplanon is a progestin implant. Like Depo-Provera, Nexplanon prevents ovulation and may stop periods. Nexplanon offers faster fertility return upon removal, while Depo-Provera may delay pregnancy by six to 10 months.

Nexplanon is a matchstick-sized implant placed in the arm. It can last up to four years without maintenance. Nexplanon’s upfront cost is higher than Depo-Provera, but often cost-effective in the long term. Depo-Provera’s cost varies by visit, provider and insurance.

• Effectiveness: Greater than 99%.
• Side effects: Acne, headaches, mood swings, sore breasts and spotting or changes in menstrual bleeding.
• Risks: Increased risk of ectopic pregnancy, along with ovarian cysts, serious blood clots, high blood pressure, gallbladder issues, rare cancerous and noncancerous liver tumors.

Several other birth control methods are available. Different types may prevent pregnancy by blocking sperm, inactivating sperm, stopping egg release, thickening cervical mucus or altering the uterus lining to prevent implantation.

The effectiveness of each type varies. Long-acting methods like sterilization are highly effective, while methods requiring active participation, like fertility tracking, have higher pregnancy rates.

Barrier Methods

These methods consist of male and female condoms, diaphragms, contraceptive sponges and cervical caps.

One significant concern is that these methods can have higher failure rates if not used correctly. However, an advantage of using barriers like condoms is that they do not produce hormonal side effects, making them a viable option for those looking for non-hormonal contraception. Additionally, condoms provide valuable protection against sexually transmitted infections, which is not the case with many other methods.

• Effectiveness: Varies from 68% to 98%, depending on type.
• Side effects: Barrier methods present the most minor side effects of any form of contraception and include minor itching, burning, and irritation.
• Risks: Allergic reactions. While cervical caps may increase the risk of toxic shock syndrome or urinary tract infections if improperly used, other barrier methods present no serious risks.

Fertility Awareness Methods

These methods require determining which days of the month you can get pregnant. They focus on signs like your body temperature and changes in your cervical mucus. To prevent pregnancy, you can choose not to have sex on those fertile days or use a barrier method of birth control.

• Effectiveness: Between 77% and 98%, depending on the method used.
• Side effects: No side effects, but it does not protect against sexually transmitted diseases.
• Risks: Unintended pregnancy or sexually transmitted disease.

Fertility awareness methods should be used cautiously if you struggle to avoid sex or use a barrier method during your fertile days. Additionally, if pregnancy poses medical risks for you, or if you have bleeding between periods that complicates distinguishing your normal cycle or assessing cervical mucus, these factors should be carefully considered.

Spermicide or vaginal gel

Spermicide is non-hormonal and either kills sperm or inhibits their movement. Phexxi is a vaginal gel that regulates pH levels in the vagina to prevent sperm from moving, making it difficult for them to reach and fertilize an egg. You apply these products in the vagina just before intercourse.

• Effectiveness: About 70% for spermicide, while Phexxi is 93% effective if used properly, about 86 percent if not used perfectly.
• Side effects: Spermicide can cause irritation to the penis or vagina, increasing the risk of infection due to irritation. Phexxi side effects include irritation, yeast and urinary tract infections, bacterial vaginosis and vaginal discharge.
• Risks: Spermicide can increase the risk of HIV or urinary tract infections.

Sterilization

Sterilization is considered a permanent form of birth control.

Vasectomy is the only sterilization option for men. It is a simple surgery where the tubes that carry sperm are cut and sealed.

Women have more choices when it comes to permanent birth control. One common method is called tubal ligation, which is a surgery that blocks the fallopian tubes to prevent pregnancy. Another option is a procedure called salpingectomy, where the fallopian tubes are completely removed.

• Effectiveness: More than 99%.
• Side effects: Surgery-related complications such as bleeding, infection or anesthesia reactions in both male and female procedures, though higher for tubal ligation.
• Risks: Ectopic pregnancy in tubal ligation.