Depo-Provera is an injection which contains a hormone called progestogen and protects you from pregnancy for 12 weeks.
How effective is it?
Depo-provera is very effective with a failure rate of less than 4 pregnancies per 1000 users over 2 years. This means it is over 99.6% effective.
How does it work?
The main way Depo-Provera works is to stop the ovaries from releasing an egg each month.
How is it given?
It is normally injected into the muscles of your bottom and needs to be given every 12 weeks.
Can anyone use Depo-Provera?
Most women who want Depo-Provera can have it. Click here to read more about conditions which may mean you could not use Depo-Provera.
Conditions which may mean you could not use Depo-Provera.
- You want to have a baby in the next year
- Now or in the past you have had breast cancer
- You have had a heart attack or a stroke
- You have had certain types of liver disease
- You have had diabetes for a long time or have complications with it
- You have risk factors for osteoporosis (thinning of the bones)
- You have high blood pressure with associated vascular disease
- You have multiple risk factors for cardiovascular disease
- You have unexplained vaginal bleeding
- You have certain types of rheumatic disease
How old do I have to be to start Depo-Provera?
Depo-Provera lowers your natural oestrogen levels, which may cause thinning of the bones. In young women, bones are still gaining strength and there are concerns that Depo-Provera may interfere with this. Your doctor or nurse is likely to encourage you to use other forms of contraception until age 18. However if other methods are not suitable, some young women do choose Depo-Provera.
What are the advantages of Depo-Provera?
Some of the good things about Depo-Provera are:
- Apart from injection visits you do not need to think much about it
- There are no serious side effects
- You can use it if you are breast feeding
- It is useful if you cannot take oestrogens, like those found in the combined oral contraceptive pill
- It may help with pre-menstrual tension and heavy periods
What are the disadvantages of Depo-Provera?
- Your periods are likely to change. Some women will have irregular bleeding or spotting and for a few the bleeding will last a long time and could be heavy. As time goes on the periods are likely to stop completely. Click here for more information about what to do if you have problems with your bleeding.
- Some women may gain weight when they use Depo-Provera.
- When you start any contraception which contains hormones, you may get some annoying side effects in the first few months. With Depo-Provera these include spotty skin, sore breasts, headaches, changes in mood and sex drive. These symptoms normally stop within a few months. Speak to your doctor or nurse if you have any concerns.
- If for any reason you decide to stop Depo-Provera any side effects, including bleeding problems may take a few months to go away
- It may take a while for your periods and fertility to return after stopping Depo-Provera.
- Depo-Provera will not protect you from sexually transmitted infections and many women continue to use condoms whilst taking Depo-Provera.
- Depo-Provera in some women can reduce the strength of their bones. For most women this is not a problem as the bones get stronger again when you stop the injection. However it may be more of a problem for those women who have risk factors for thin bones (osteoporosis). Click here for more information.
Problems with bleeding.If you have problems with bleeding then discuss it with your doctor or nurse. It may be that some tablets would help to control the bleeding. Your doctor or nurse may also wish to check the bleeding is not due to some other causes, such as infection. Even if you do decide to stop Depo-Provera the bleeding problems could continue for some months.
Risk factors for osteoporosis
- Periods stopping for 6 months or more because of dieting, an eating disorder or over exercising
- Heavy drinking
- Long term use of steroids
- Close family history of osteoporosis
- Certain medical conditions that affect the liver, thyroid or digestive system
Are there any serious risks linked with using Depo-Provera?
- As discussed in the section above ‘What are the disadvantages of Depo-Provera?’ there may be some thinning of your bones.
- There may be a small increase in the risk of breast cancer in women who have used hormonal contraception but Depo-provera may give you some protection against cancer of the womb.
- You may have an allergic reaction to the injection or develop an infection at the site of injection but these are both very rare.
Will my weight be affected by the use of Depo-Provera?
Some though certainly not all women put on weight whilst on Depo-Provera.
should I have my first injection of Depo-Provera?
It is usual to start Depo-Provera within the first 5 days of your period. This means you will be immediately protected from pregnancy. If it is not possible to start in this way your doctor or nurse will discuss other options with you. If you are given Depo-Provera after the first 5 days of your period you will not be protected from pregnancy for 7 days after the injection.
When should I have subsequent injections of Depo-Provera?
You need to have injections every 12 weeks. The doctor or nurse who gives you the injection should tell you when your next injection is due. If you are unable to make this date discuss whether it is possible to come earlier. If you do not manage to attend at 12 weeks you need to use alternative contraception such as condoms until your Depo-Provera injection is given and often you will need to continue to do this for another 7 days after that. If you are overdue for an injection and do have unprotected sexual intercourse you may need emergency contraception such as the ‘morning after pill’. See our section on emergency contraception about this.
Can anything make Depo-Provera less effective?
- There are no medicines that you can be prescribed or buy in a chemist in the UK which will make Depo-Provera less effective.
- Diarrhoea and vomiting does not affecte Depo-Provera
How long can I use Depo-Provera for?
Many women who use Depo-Provera do so for just a few years but some use it for longer. If you wish to use it for more than 2 years your doctor or nurse will regularly ask you questions to work out whether you are at particular risk of osteoporosis and then together you can decide what would be best for you.
It is important that you are happy with the type of contraception you choose to use. Doctors and nurses are trained to work with you to find a method of contraception that suits you. Do not be afraid to discuss any concerns you may have.