It prevents ovulation, so there is no egg available for sperm to fertilize. It thickens your cervical mucus—this makes it harder for sperm to swim. The progestin in Depo-Provera can also thin out or prevent the uterine tissue that builds each month. This makes it difficult for a fertilized egg to implant into the uterine wall since there is not enough lining there to receive it.
Depo-Provera shots can also help treat the pain associated with endometriosis.
To have pregnancy protection for a full year, it is important to schedule your Depo-Provera or Depo-subQ Provera 104 shots approximately every 12 weeks. Over the course of one year, you should receive four depo shots.
Side Effects
Your body may go through changes as it adjusts to the progestin in Depo-Provera. To increase your success with depo, it may be helpful to know what to expect during the first year of use.
Before you begin your first depo shot, it is important that you are aware of the possible bleeding side effects that may occur while using Depo-Provera. Unfortunately, there is no way to know ahead of time if these side effects will occur or how long they will last.
Research suggests that women who know ahead of time about the potential for either irregular (spotting) bleeding or prolonged, continuous bleeding are more likely to continue using Depo-Provera.
Many women are willing to go through the initial bleeding in exchange for the chance of not having to have a period anymore.
Depo will also provide you with continuous pregnancy protection if you have switched from another hormonal method and received your first depo shot within the last seven days of using that method (such as combination birth control pills, NuvaRing, or the Ortho-Evra patch).
Generally speaking, it takes about three months for your body to adjust to Depo-Provera. Similar to other hormonal birth control methods, your body needs this time to get used to the hormone (progestin) in Depo.
Expected Side Effects
As your body is adjusting to Depo-Provera, it is likely that you will experience irregular bleeding (spotting) or prolonged bleeding (like a continuous period). This symptom is considered completely normal.
Other Depo side effects that you may experience include skin reactions, weight gain, and pain (associated with the actual injection).
Less common side effects include: change in sex drive, depression, nervousness, dizziness, nausea, change in appetite, headaches, skin rash or spotty darkening of the skin, sore breasts, hair loss, or increased hair on the face or body.
As your body adjusts to the progestin, these side effects should lessen and go away. For some women, these side effects may continue until the Depo shot wears off (11 to 14 weeks).
Making Next Appointment
It is recommended that you make an appointment for your next scheduled Depo shot during the same healthcare provider’s visit that you receive your first shot:
If you are using the original Depo-Provera shot, make your appointment for your second injection within 11 to 13 weeks. If you are using Depo-subQ Provera 104, your next shot should be in 12 to 14 weeks.
If you are satisfied with your decision (or are still unsure but want to continue using Depo-Provera), it is time for your second Depo-Provera shot.
During months four through six, it is still considered normal if you are experiencing sporadic bleeding. Most women who use Depo-Provera report that their irregular spotting tends to lessen with each shot. In fact, by the end of month six, 39% of women usually have had their periods stop completely.
Weight Gain
At this point, you may or may not notice changes to your weight. Weight gain is a common side effect. Use this healthcare provider’s visit to discuss a possible exercise and diet plan with your healthcare provider. If you eat sensibly and exercise often, you can help reduce the changes in your weight that may stem from using Depo-Provera.
Preventing Bone Loss
Depo-Provera has a black box warning that advises women that continued depo use may cause bone mineral density loss. Because of this, this depo shot appointment is also a good time to ask your healthcare provider about recommendations for maintaining adequate calcium intake.
Here are some common suggestions for getting enough calcium to prevent losing bone mineral density when using Depo-Provera:
Calcium supplements and vitamin D Getting enough calcium in your diet in ways including eating lots of vegetables Exercise to prevent osteoporosis including weight-bearing and muscle-strengthening exercises that may help in countering any potential calcium loss to your bones
Your healthcare provider may also suggest that you stop smoking (if you are a smoker) and to limit or cut out any alcohol consumption.
Making Next Appointment
You should also make an appointment for your next scheduled depo shot during the same healthcare provider’s visit that you receive your second shot.
If you are using the Depo-Provera shot, make your appointment for your third injection within 11 to 13 weeks. If you are using Depo-subQ Provera 104, your next shot should be in 12 to 14 weeks.
This will ensure that your pregnancy protection continues.
At this point, it is important to be maintaining a healthy lifestyle to help counteract any weight gain or calcium loss associated with Depo-Provera. Keep taking your calcium supplements if your healthcare provider had recommended their use.
Exercise
You should also be exercising. Your routine should including weight-bearing exercises that will help to keep your bones strong. Plus, a regular, heart-healthy exercise that will help burn off extra calories:
Weight-bearing exercise can include walking, hiking, or running. Heart-healthy forms of exercise can include bicycling, yoga, or swimming.
Making Next Appointment
To make sure that your pregnancy protection continues, schedule an appointment for your next depo shot during the same healthcare provider’s visit that you receive your third shot:
If you are using Depo-Provera, make your appointment for your fourth injection within 11 to 13 weeks. If you are using Depo-subQ Provera 104, your next shot should be in 12 to 14 weeks.
You may also be experiencing the added benefit of not having your period anymore. If your period has not completely stopped by the end of the first year, don’t fret. With continued Depo-Provera use, it will most likely stop within the following months.
Making Next Appointment
After using Depo-Provera for a year, you will most likely need to schedule your annual gynecological exam. You can arrange to receive your fourth depo shot during this appointment.
This is a good time to discuss with your healthcare provider whether or not to continue with your depo shots. If you choose to stay on Depo-Provera, make an appointment for your next scheduled injection (11-14 weeks).
Restoring Fertility
If you want to become pregnant, you should stop your Depo-Provera shots one year before the time you plan to begin trying to get pregnant. It takes several months to regain fertility and begin ovulating after receiving your last Depo-Provera shot, and an average of nine to 10 months (sometimes more than a year) to conceive.
Two-Year Limit
A 2004 FDA advisory recommended that women stop using Depo-Provera or Depo-subQ Provera 104 after two years of continued use due to the potential for bone density loss.
You should continue with your depo shots (for more than two years) only after weighing the benefits vs. risks of continued use, and you and your healthcare provider have determined that there this is the birth control method for you to be using.
