Depo Provera: Your Guide to the Contraceptive Shot

The Depo Provera (or Depo-Ralovera) is a contraceptive injection containing artificial progesterone, progestin. The injection goes into your buttocks or arm, and works for about three months.^1,2

The shot starts working immediately if you have just finished your period, but after that you may have ovulated, so the egg may be in your system, and can therefore be fertilised.

Your doctor will advise you regarding the timing of your shot. The shot contains Depot Medroxyprogesterone Acetate (DMPA) which stops you from ovulating, and therefore prevents pregnancy – if there is no egg to be fertilised, no pregnancy can occur.

The Depo Provera is 99 per cent effective at preventing pregnancy, but does not offer protection against sexually transmitted infections. About half of all women will stop getting periods entirely after one year of use.³

Your normal fertility should return three to four months after ceasing injections, but many women find it difficult to conceive after using the Depo Provera contraceptive shot, up past two years.⁴

Who should avoid the Depo Provera injection

Anyone with unexplained vaginal bleeding
Liver disease
Breast cancer
Blood clots
Those with osteoporosis
Teens
Anyone wanting to get pregnant within two or three years

Possible side-effects of the Depo Provera contraceptive injection

Irregular or absent menstrual periods
Irregular bleeding
Headaches
Nervousness or anxiety
Depression
Dizziness
Acne
Appetite changes (increases)
Weight gain
Facial hair
Body hair
Hair loss
Loss of bone mineral density

References

1.
Jacobstein R, Polis CB. Progestin-only contraception: Injectables and implants. Best Practice & Research Clinical Obstetrics & Gynaecology. Published online August 2014:795-806. doi:10.1016/j.bpobgyn.2014.05.003
2.
Halpern V, Brache V, Taylor D, et al. Clinical trial to evaluate pharmacokinetics and pharmacodynamics of medroxyprogesterone acetate after subcutaneous administration of Depo-Provera. Fertility and Sterility. Published online April 2021:1035-1043. doi:10.1016/j.fertnstert.2020.11.002
3.
Gallo MF, Grimes DA, Lopez LM, Schulz KF, d’Arcangues C. Combination injectable contraceptives for contraception. Cochrane Database of Systematic Reviews. Published online October 8, 2008. doi:10.1002/14651858.cd004568.pub3
4.
Damtie Y, Kefale B, Arefaynie M, Yalew M, Adane B. Fertility return after hormonal contraceptive discontinuation and associated factors among women attended Family Guidance Association of Ethiopia Dessie model clinic, Northeast Ethiopia: A cross-sectional study. Rosenbaum JE, ed. PLoS ONE. Published online July 11, 2023:e0287440. doi:10.1371/journal.pone.0287440