Contraceptive Pearl: Self-Administered Progestin Injection: Depo SubQ
Depot medroxyprogesterone acetate (DMPA) can be prescribed as a subcutaneous injection that patients give themselves at home. This method, also known as Depo SubQ, contains the same hormone, works in the same way, and has the same medical eligibility criteria as the in-office injection. Depo SubQ has a smaller needle (28 gauge x 3/8 inch) on a pre-filled, single-use syringe and is meant to be injected into the thigh or abdomen. It contains about 30% less progestin than the in-office form, which may reduce some of Depo’s side effects.
While Depo SubQ was approved by the FDA in 2004, its use has been limited, possibly due to providers’ concern about patients’ ability to inject the medication correctly. However, a study conducted in 2014 found that a brief educational session using the information in the package insert was sufficient. In this study, patients with clinic and self-administration had very similar rates of efficacy and continuation, and 90/91 patients were able to self-administer Depo SubQ after a brief training. To train, the study-administrator taught the patients using modified illustrations from Pfizer’s guide “Instructions for the use of depo-subQ provera 104.” The patients then performed the initial injection in the thigh or abdomen under supervision and, if deemed acceptable, were given a self-administration kit to take home including a prefilled syringe and needle. Patients also received specific instructions on how to restart Depo SubQ off schedule using the Quick Start protocol in case of temporary discontinuation.
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Helpful Resources
Depo SubQ: The Do-It-Yourself Birth Control Shot
The Shot (Depo Provera) User Guide
Contraceptive Pearl: The Shot (Depo Provera) 101
Instructions for the Use of Depo-SubQ Provera 104
Sources
Morse J, Slough L. Depo SubQ: The do-it-yourself birth control shot, Bedsider. 2015.
Pharma-free
The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.
