Home
Contact Us Site Map Search
Reproductive Health Technologies Project  
Leadership Transition Abortion Contraception STDs Fertility News & Publications About Us
  Print this page  
 
Depo Provera
 
 

Frequently Asked Questions about Depo Provera

What is Depo Provera?
How does Depo Provera work?
What are the side effects of Depo Provera use?
What are other possible health effects of Depo Provera?
What is a "black box" warning and why was it applied to Depo Provera?
Why would a woman choose Depo Provera over other methods of contraception?

Don't see your question here? Let us know.

What is Depo Provera?
Depo Provera is an injection of synthetic progesterone similar to one of the hormones made by a woman’s ovaries.  Approved by the FDA in 1992, Depo Provera is a highly effective, long-acting method of contraception.  When used consistently, it is more than 99% effective at preventing pregnancy.1  A woman who chooses Depo Provera as her method of contraception returns once every 12 weeks to a healthcare provider for re-injection.   

back to top

How does Depo Provera work?
Depo Provera prevents pregnancy by reducing the amount of estrogen a woman’s ovaries make, similar to what happens to women during and after menopause. Like other progestin-only contraceptives (which contain no estrogen), it works to prevent pregnancy by inhibiting ovulation and by altering the environment in the cervix and uterus to make it harder for sperm to travel.  Depo Provera does not protect against sexually transmitted infections, including HIV/AIDS.

back to top

What are the side effects of Depo Provera use?
Women who use Depo Provera may experience side effects, the incidence and severity of which vary from person to person.  Similar to other methods of hormonal contraception, the most frequently reported side effects included menstrual irregularities, abdominal pain or discomfort, weight gain, dizziness, headache, fatigue and nervousness.  Some women also experience breast tenderness, depression, and decreased libido.2    

back to top

What are other possible health effects of Depo Provera?

Sexually-transmitted infections.  Recent data suggest an increased risk of HIV infection with use of Depo Provera compared to other forms of hormonal contraception.3 After reviewing all available evidence, the World Health Organization affirmed that Depo Provera and other methods of hormonal contraception remain safe and effective.4  Women at risk of acquiring or spreading a sexually-transmitted infection should use male or female condoms.

Weight gain.  Some studies have found a link between contraceptive injection use and weight gain, particularly among obese adolescents.5 One study linked early weight gain to Depo Provera use in adolescents to a risk of excessive weight gain in subsequent years.6 Women who are concerned about weight gain should discuss their contraceptive options with their provider.

Breast cancer.  A recent study linked Depo Provera use of one year or longer to a 2.2 fold increase in risk of breast cancer.7  The risk dissipated within months after use was discontinued and those using the injection for less than a year did not experience increased risk.  The health community believes that while this risk should be noted, the benefits of Depo Provera in preventing pregnancy outweigh the risks associated with the drug.8  The study did not prove a cause and effect relationship and many health professionals have noted the study’s limitations – many of the women who showed increased risk had a family history of breast cancer and were women who did not have children, another known risk factor of breast cancer.9

Bone mineral density.  Women and adolescents using Depo Provera may experience a decrease in bone mineral density.  This loss is believed to be associated with the injection’s interference with the production of the hormone estradiol, which is involved in bone mineral density development.  Bone mineral density levels should return to normal levels once the injection is stopped, though not all studies support full recovery after discontinuation.  In adolescents, this side effect is of special concern because density loss occurs at the same time when bone growth is occurring and mineral levels should be increasing.1011

back to top

What is a "black box" warning and why was it applied to Depo Provera?
The “black box” warning is the Food and Drug Administration’s (FDA) most stringent caution short of an outright ban.  A “black box” warning is designed to inform healthcare providers and consumers about serious and imminent problems associated with use of a drug. 

FDA applied the “black box” warning to Depo Provera because its use may lead to bone mineral density loss.  Bone mineral density loss is an important concern, but not comparable to the types of side effects typically presented in a “black box” warning – adverse reactions that could cause imminent harm, injury, or death.  FDA’s history of putting politics before science in its handling of reproductive health products raise questions about the reasons FDA chose to apply the “black box” warning to Depo Provera.

back to top

Why would a woman choose Depo Provera over other methods of contraception?
Women who are trying to prevent pregnancy choose contraceptive methods for a variety of reasons.  While effectiveness and convenience are the primary factors women cite for why they choose their method, many women face unique situations that may warrant use of a certain type of contraception.  Reasons why a woman might choose Depo Provera over another method include:

Depo Provera is a progestin-only contraceptive method.  Many women who want a hormonal contraceptive method experience unmanageable side effects from use of estrogen.

Depo Provera is highly effective and reliable.  There is only a slight difference between effectiveness with perfect (99.7%) and typical use (97%) and since it is an injectable, there is less room for user error, i.e. missing a Pill or inserting a diaphragm incorrectly.

Depo Provera is long-acting.  A woman only has to manage her contraception once every 12 weeks when she returns for re-injections.

Women can use Depo Provera covertly. Since there are no pill packs or barrier methods to store or action to take after injection, Depo Provera can be used discreetly by women who wish not to disclose contraceptive use to family members or partners.

  • back to top


1 Planned Parenthood.  Available at http://www.plannedparenthood.org/health-topics/birth-control/birth-control-shot-depo-provera-4242.htm.  Accessed on June 1, 2012.

2 American College of Obstetricians and Gynecologists (ACOG). Implants, injections, rings and patches: Hormonal birth control options. Available at: http://www.acog.org/~/media/For%20Patients/faq159.pdf?dmc=1&ts=20120531T1913559613  Accessed on May 29, 2012

3 Morrison C. Hormonal contraception and the risk of HIV acquisition among women in South Africa. AIDS. February 2012; 26: 497-504.

4 World Health Organization. Hormonal contraception and HIV. Available at: http://www.who.int/reproductivehealth/topics/family_planning/hc_hiv/en/index.html  Accessed on May 29, 2012.

5 Edelman A. Contraceptive considerations in obese women. Society of Family Planning Clinical Guidelines. November 2009;1:1-8.

6 Bonny A. Early weight gain related to later weight gain in adolescents on depot medroxyprogesterone acetate.   Journal of Obstetrics and Gynecology. April 2011; 117: 793-797.

7 Li C. Effect of depo-medroxyprogesterone acetate on breast cancer risk among women 20 to 44 years of age.  Cancer Research.  April 2012; 72: 2028-2035.

8 Knowledge for Health. Exploring the link between injectable contraception and breast cancer. Available at: http://www.k4health.org/blog/post/exploring-link-between-injectable-contraception-and-breast-cancer Accessed on May 30, 2012.

9 National Institutes of Health – Medline Plus. Depo provera birth control might raise breast cancer risk. Available at: http://www.nlm.nih.gov/medlineplus/news/fullstory_123732.html Accessed on May 30, 2012.

10 American College of Obstetricians and Gynecologists (ACOG). Implants, injections, rings and patches: Hormonal birth control options. Available at: http://www.acog.org/~/media/For%20Patients/faq159.pdf?dmc=1&ts=20120531T1913559613 Accessed on May 29, 2012.

11 National Women’s Health Network. Depo provera and bone mineral density. Available at: http://nwhn.org/depo-provera-and-bone-mineral-density Accessed on May 29, 2012.

 

back to top

 
Resources

Answers to Frequently Asked Questions about the Lastest Research on Health Risks Associated with Depo Provera

 
 
Abortion | Contraception | STDs | Fertility | News & Publications | About Us
Contact Us | Site Map