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The Depo shot 101: Everything you need to know

Jenni Miller By | Updated on June 4, 2020
Medically reviewed by Karen Berger, Pharm.D.

There are a variety of birth control options for women. But not all options are equal. If you’ve been cleared by your healthcare provider to use hormonal birth control and you would like to avoid the hassle of remembering to take daily pills or fiddling with a hormone patch, you might want to consider the birth control shot—Depo-Provera

What is the Depo shot?

Also known as the Depo shot, the birth control shot, or DMPA, Depo-Provera is an incredibly effective, safe, and reversible birth control method that first became available in 1992. A recent CDC study revealed that almost 25% of women who used birth control prevention during the years 2011 to 2015 had tried the birth control shot, making it a more common option during that time frame than the IUD or hormone patch

Although it’s not as long-acting as the implant or IUD, the birth control shot does last longer than the pill or patch since every dose of the shot is effective for approximately three months. 

How does the Depo shot work?

Depo-Provera is an injectable form of birth control that uses 150 mg of the hormone medroxyprogesterone acetate (a progestin) to stop ovulation and thicken your cervical mucus. It’s typically injected into your upper arm or buttock by your healthcare provider at his or her office every 12 to 13 weeks. Depo-Provera is an IM (intramuscular injection), which means that it is injected into a muscle. It is available in both brand-name and generic form. 

(Depo-Provera is also available at a lower dose under the name Depo-SubQ Provera 104, but there is no generic available in that dose.) This version is a subcutaneous injection, which means that it is injected just under the skin. 

The Depo shot begins working immediately with no need for backup birth control if you get it within seven days of the first day of your menstrual period. If you get your contraceptive injection outside of this time frame, you’ll need to abstain, or use a backup method (like condoms) for a week after your first shot.

The birth control shot is 99% effective at preventing pregnancy when it’s administered perfectly on time, which is somewhere between 12 to 13 weeks. If you’re unable to make it to your healthcare provider’s office in that time frame or if you forget to make a follow-up appointment, the Depo-Provera shot’s effectiveness drops to 94%, and you may have to get a pregnancy test before your next dose. 

Are there any Depo shot side effects? 

Most common side effects associated with Depo-Provera go away after two or three months of beginning the shot, but here are a few to keep in mind: 

  • Irregular bleeding
  • Bloating
  • Breast tenderness
  • Bruising or tenderness at the injection site
  • Cramping
  • Decreased sex drive
  • Depression
  • Fatigue, weakness, or tiredness
  • Headaches
  • Irregular menstrual periods, including no period at all
  • Nausea
  • Nervousness
  • Weight gain 

If you experience heavy vaginal bleeding, severe migraine with aura, an allergic reaction, and/or severe depression, contact your healthcare provider for medical advice immediately. 

Depo-Provera may increase your risk of certain cancers and ectopic pregnancy, and it shouldn’t be used by anyone who has or has had breast cancer. 

What are the advantages of the Depo shot?

 

  • Privacy: Only you and your healthcare provider need to know that you’re on birth control.

 

  • Convenience: It doesn’t require a daily dose. There’s also no need to use a condom for pregnancy prevention—but condoms should still be used to prevent sexually transmitted infections. 
  • Period symptoms: The birth control shot could lessen your menstrual flow or even stop it altogether, and it can also help with cramping and pain.
  • Health benefits: It can decrease endometriosis and uterine fibroids, as well as the risk of endometrial cancer. 

You can increase your odds of getting your shot on time if you use a calendar or app with reminders, if your healthcare provider’s office provides courtesy calls or emails when it’s time to schedule your next appointment, or if you schedule your next shot at the time of your current appointment. Remember, the shot is more effective when you are on time for your injection. 

What are the disadvantages of the Depo shot?

These are the more serious concerns to weigh when you’re considering Depo-Provera, according to the U.S. Food and Drug Administration (FDA).

  • Fertility: It may take up to several months for your menstrual cycle to return to its normal schedule, and it could significantly delay your ability to conceive up to 18 months after your last shot. (The median time is 10 months but may range from four to 31 months.) 
  • Sexually transmitted diseases: The birth control shot doesn’t protect against STDs, so condoms and other barrier methods are still required for safer sex.
  • Loss of bone density: You and your healthcare provider discuss your risk factor for osteoporosis beforehand. The U.S. Food and Drug Administration has recommended that Depo-Provera not be used longer than two years because some patients do experience loss of bone mineral density, which may be significant. The FDA label states that bone loss is greater with a longer duration of use and may not be completely reversible. Patients are encouraged to take vitamin D and calcium to prevent bone loss. Ask your healthcare provider what dose you should take. 
  • Scheduling: If it’s difficult to get to your healthcare provider’s office or if you’re prone to forgetting appointments, you might want to opt for a birth control method that you can take yourself, like birth control pills or hormonal patches, or more long-term methods like the IUD.

How much does the Depo shot cost?

If you’re paying completely out of pocket, the generic (medroxyprogesterone acetate) will run you around $104, but most insurers and Medicare cover at least part of the cost, if not all of it. Depending on the pharmacy, the out-of-pocket cost for non-generic (brand-name) Depo-Provera could run you around $250 a dose.

There are plenty of ways to lower your drug costs if you’re savvy by comparing prices, talking to your pharmacist, or using a Depo-Provera coupon from SingleCare. Your prescriptions may be even cheaper without insurance. Here’s a guide on how to find low-cost or even free birth control, with or without insurance.