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Contraceptive Pearl: The Shot (Depo Provera) 101

What is Depo Provera?

Depo Provera (Depo) is a progestin injected into the upper arm every three months. Depo is 99% effective in preventing pregnancy.

What are Depo’s side effects?

Depo’s side effects include spotting, amenorrhea, depression, change in appetite, weight gain and headaches. After women stop using Depo, return to normal fertility occurs gradually over many months.

What about bone density?

In 2004, the FDA gave Depo a black box warning related to bone density loss. Although Depo users do lose bone density at first, bone density plateaus after the first two years and recovers soon after injections end. We don’t know how Depo affects its users’ risk of fracture later in life. We do know, however, that factors other than medication (including diet, exercise, and weight) have a greater influence on bone density. We also know that teen pregnancy causes more much more bone loss than Depo does.

Many clinicians stopped recommending Depo after 2004 (or placed restrictions on their patients’ duration of treatment). However, Depo remains a good choice for many women and teens – even for long-term use.

Why do patients like Depo?

Depo is convenient, private, and simple to use. It causes amenorrhea, ridding many patients of menstrual symptoms. Lastly, it’s a good choice for patients who can’t take estrogen.

Don’t forget about Depo! It’s a great contraceptive option.

We appreciate your feedback! Please write us at pearls@reproductiveaccess.org with any questions, comments or additional resources to add to our list.

 

Helpful Resources

The Shot (Depo Provera) User Guide 

Your Birth Control Choices

 

Sources

Kaunitz AM, Arias R, McClung M, Bone density recovery after depot medroxyprogesterone acetate injectable contraception use, Contraception. 2008 Feb;77(2):66-76.

Lopez LM, Grimes DA, Shulz KF, Curtis KM, Steroidal contraceptives: effect on bone fractures in women, Cochrane Review of Systematic Reviews. 2009 Apr 15;(2):CD006033.

 

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.

 

Contraceptive Pearls

This monthly clinical e-newsletter highlights evidence-based best practice for contraceptive care

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