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Depo-Provera, commonly referred to as the birth control shot, is the brand name of the medication depot medroxyprogesterone acetate, or DMPA for short. DMPA contains progestin, a synthetic hormone that works like progesterone, the female sex hormone.

The Food and Drug Administration (FDA) approved DMPA as a contraceptive in 1992. With a 99 percent efficacy rate, it’s considered highly effective at preventing pregnancy.

You might notice this form of birth control is sometimes called the Depo shot, or simply “the shot.” In the context of birth control, these all refer to the same thing: a contraceptive injection that contains progestin.

Pros

  • No need to take a daily pill. You’ll get a shot once every 12 to 13 weeks.
  • Less opportunity to miss a dose. It’s very common to occasionally miss a daily pill. With a shot, you won’t have to worry about forgetting to take your pill — or wonder if you took one already.
  • Depo-Provera doesn’t contain estrogen. Can’t take combination birth control pills, or other hormonal contraceptives that contain estrogen? You can still get the shot.

Cons

  • The shot doesn’t provide protection from sexually transmitted infections (STIs). Unless you and your partner(s) are fluid bonded, you’ll need to use barrier methods of birth control, like internal or external condoms, to help prevent STIs.
  • You might notice some period-related side effects, particularly during your first year of use. This can include spotting (light bleeding) between periods, lighter periods, longer or irregular periods, or no periods at all.
  • You’ll need to schedule an appointment to get your shot every 3 months. The shot doesn’t require daily upkeep, but you will need to visit a doctor’s office or other healthcare clinic to get the shot once every 12 to 13 weeks. If you need to delay the appointment by more than 2 weeks, you’ll need a backup method of birth control.
  • The shot can temporarily affect fertility. Once you stop getting the shot, it may take up to 18 months before you can become pregnant. Another birth control method may be a better option if you’re considering pregnancy within the next 2 years.

The shot works by blocking ovulation, or the release of an egg from your ovaries. If you don’t ovulate, you can’t become pregnant.

The progestin in the injection also thickens the mucus on your cervix to help prevent sperm from getting through the cervix to the egg. This thickening of the cervical mucus offers additional protection against pregnancy, in the unlikely event that ovulation happens.

For some people, getting a shot every few months is more convenient than taking a pill every day or applying a patch once a week. Just know you still have to follow the shot’s timeline closely to prevent pregnancy.

Here’s how it works:

  • The shot prevents ovulation for about 14 weeks. You can go a maximum of 15 weeks between shots before the shot no longer prevents pregnancy.
  • Your doctor or clinician will most likely recommend scheduling your appointments every 12 to 13 weeks. You can get your next shot before the previous one “expires.”
  • If more than 15 weeks have passed since your last shot, and you have penis-in-vagina (P-in-V) intercourse, you may become pregnant. If there’s a chance you could be pregnant, your clinician may ask you to take a pregnancy test before they give the next shot.
  • To prevent pregnancy, you’ll want to use a backup method until you can get your next shot and for 7 days after the shot. If you have P-in-V intercourse without a backup method, you can use emergency contraception to help prevent an unplanned pregnancy.

Only you can choose the best type of birth control for your health needs and lifestyle. As you consider your options, it may help to ask yourself a few key questions:

  • What potential side effects am I fine with? What side effects do I prefer to avoid?
  • Will I remember to use a daily birth control method?
  • Do I want my birth control to treat other concerns, like acne or painful periods?
  • Do I want to try getting pregnant within the next 2 years?
  • How much do I want to pay?
  • Do I need to avoid combination birth control pills because of certain risk factors?
  • Do I want my birth control to help protect against STIs?

Not sure how to answer some of these questions? A doctor or clinician can always offer more information about your available options for birth control, along with more personalized recommendations based on your individual health history and lifestyle.

You might prefer the shot to other forms of birth control if you:

Another potential benefit of the shot? Many people using this form of birth control report lighter, less painful periods. Your periods may even stop completely.

Some people prefer the shot for this very reason. If you’re transgender, nonbinary, or gender nonconforming, having a period could lead to feelings of gender dysphoria. For that matter, so can a daily birth control pill.

Getting a shot once every 3 months offers an alternate approach that could help reduce dysphoria, plus potentially lead to fewer or no periods.

Keep in mind, though, that period-related side effects can vary. Some people who get the shot report spotting and longer periods. Another common side effect is weight gain, which could increase chest size.

If the shot sounds like a good fit for you, reach out to your doctor’s office, OB-GYN, or local health clinic to make an appointment.

At your appointment, the clinician will go over your health history to make sure it’s safe for you to receive the shot. They may ask questions about:

  • other types of birth control you’ve used in the past
  • any side effects you experienced
  • your last period
  • the possibility of pregnancy

If there’s any chance you could be pregnant, you’ll typically need to take a pregnancy test before you can get the shot.

Some healthcare professionals may also recommend getting the shot:

  • during the first 5 days of your period
  • within 5 days after giving birth, or by the 6th week postpartum if you nurse exclusively
  • within a week of having a miscarriage or abortion

If there’s no possibility of pregnancy, you can get the shot at any time.

If you do get the shot within 5 days of starting your period or within 5 days of giving birth, you’re protected from pregnancy immediately. The shot will have time to take effect before you ovulate, in other words. Otherwise, you’ll want to use a backup birth control method for 7 days to avoid an unplanned pregnancy.

As for the injection itself, it can go into your upper arm or buttocks. You can choose where you’d like to get the shot.

Remember: You’ll need to return to a doctor’s office or clinic every 11 to 14 weeks to get your next shot, so it might help to schedule your next appointment before you leave.

The shot is highly effective. Research from 2021 noted that only 3 percent of people using the shot had an unplanned pregnancy.

Research from 2013 suggested that with perfect use, your chances of unplanned pregnancy are only about 0.2 percent during the first year.

Your chances of becoming pregnant increase if you don’t receive the shot on time. This helps illustrate the difference between perfect use and typical use.

Perfect use might involve getting the shot every 13 weeks on the dot with no variation.

Typical use, on the other hand, accounts for the fact that things don’t always happen according to plan. Maybe you get sick and have to reschedule your appointment past the 15-week mark, or you have P-in-V sex without a backup method during the window when you aren’t protected.

Even with typical use, the shot remains one of the most effective forms of birth control: About 6 percent of people will experience an unplanned pregnancy in the first year.

Only IUDs and Implanon, the birth control implant, are more effective.

Your care team may decide to give a slightly lower dose of the shot if you have a high risk for diabetes or heart disease, or if you weigh under 100 pounds.

Older research suggested even this lower dose works to prevent pregnancy 99 percent of the time.

More recent research from 2010, however, suggested there’s no need to adjust the dose for body weight.

The shot isn’t right for everyone. A doctor or clinician typically won’t prescribe the shot if you have:

If you have diabetes or high blood pressure and want to get the shot, your care team will need to monitor your symptoms carefully. Hormonal birth control can affect both blood pressure and glucose tolerance, so if there’s any change in your condition, they may recommend another method.

Progestin can also worsen migraine, major depression, or epilepsy. If you live with any of these conditions, your care team may recommend trying another birth control method.

The shot affects everyone differently, and it can cause a number of side effects.

Weight gain and changes in your menstrual cycle are the most common side effects, according to 2021 research.

Some people who use the shot notice their periods become lighter over time or completely stop after several months of use. This is safe.

However, other people using the shot might have longer, heavier periods. Spotting, or bleeding between periods, is also common.

Other possible side effects include:

People assigned female at birth can use the shot to prevent pregnancy while taking gender-affirming hormones, like testosterone.

The shot also has an off-label use as a more affordable puberty blocker, though experts consider it less effective than the standard GnRH analogue medications used to suppress puberty in transgender youth.

The shot itself hasn’t been approved as a hormone therapy treatment, though results of a small 2019 study exploring its effects for transgender women suggested it could help lower testosterone with few side effects. Among the 39 women who received it, 11 noticed less facial hair, while 26 noticed breast growth.

Nursing your baby? You can still get the shot. It’s safe to use when nursing, according to Planned Parenthood, and it won’t affect your baby or the amount of milk you produce.

If you’re nursing exclusively, the manufacturer recommends waiting until 6 weeks after childbirth to receive your first dose.

Effects on bone mineral density

Because the shot can lead to a decrease in bone density over time, some experts recommend getting the shot for only 2 years or less, especially if you can use other methods of birth control.

Your clinician may also recommend trying another method during your teen years and early 20s, since adolescence and young adulthood are important times for bone density development.

If you can’t use other birth control methods, they may recommend taking calcium and vitamin D supplements as long as you continue getting the shot. These supplements can help protect against bone thinning.

When to connect with your care team

It’s always best to share any side effects you experience with a doctor or clinician, especially side effects that make daily life more difficult. They can help monitor side effects and offer guidance on switching to another type of birth control, if needed.

You’ll want to get medical attention as soon as possible if you notice:

  • jaundice, or yellowing of your skin and the whites of your eyes (This can suggest liver disease or cirrhosis.)
  • breast or chest lumps
  • sharp pain in your chest, shortness of breath, and blood in your cough (This can suggest a blood clot in your lung.)
  • pain and swelling in your calf or lower leg (This can suggest a blood clot in your leg.)
  • signs of a stroke, including:
    • sudden dizziness
    • fainting
    • severe headache
    • vomiting
    • trouble seeing or speaking clearly
    • numbness in your limbs
  • severe abdominal pain or tenderness on one side (This can suggest an ectopic pregnancy.)
  • unusual or prolonged vaginal bleeding, including:
    • bleeding heavily between periods
    • heavy bleeding that doesn’t stop
    • anything else that seems out of the ordinary (besides light bleeding between periods, which is common)
  • pain, redness, blood, or pus near the site of the injection
  • itchy skin, hives, or difficulty breathing
  • worsening depression

It’s also a good idea to reach out to your care team right away if you live with any of the conditions listed below and notice any changes in your health while using the shot:

  • diabetes
  • high blood pressure
  • depression
  • asthma
  • migraine
  • epilepsy

Hormonal birth control can sometimes lead to worsened symptoms of certain chronic health concerns.

How can I prepare for my first shot?

Before you get the shot, you’ll want to:

Depending on when you get your first shot, you may want to plan on a backup method of birth control for the first week.

But you won’t need to use a backup method after any following shots you get, unless more than 15 weeks pass between them.

Do I need to do anything else?

For maximum effectiveness, you’ll want to schedule an appointment to get your shot every 12 to 13 weeks (that’s about every 3 months, or 4 times a year).

It may help to make your next appointment before leaving the doctor’s office or clinic. You can also jot down a reminder on your calendar or use an app to help you remember to make your next appointment.

Barrier methods of birth control can further lower your chances of unplanned pregnancy and help protect against STIs.

Where do I get the shot?

You can get a prescription for the shot from a doctor or OB-GYN or at a health clinic, like Planned Parenthood.

Some pharmacies offer on-site birth control consultations, so you may also be able to get the shot at your local pharmacy.

Birth control websites, like Nurx, also offer birth control consultations and prescriptions for the shot online. Of course, if you get a prescription for the shot online, you’d need to inject it yourself.

How much does it cost?

The cost of the shot depends on where you get it and if you have insurance.

At Planned Parenthood, you might pay up to $150 for the shot itself, and up to $250 if your clinician recommends an exam first. But that’s if you don’t have insurance.

Health insurance or Medicaid might completely cover the cost of the shot, so you could pay nothing at all.

Planned Parenthood also offers sliding scale fees. If you don’t have insurance, you may be able to get lower cost birth control services, depending on your income.

If you’re ordering the shot online to inject it yourself, you’ll pay $15 for a medical consult and $75 for each dose. Again, that’s if you don’t have insurance. Many insurance plans completely cover the cost of birth control.

Learn more about getting free or lower-cost birth control.

What can I do about the side effects?

There’s no way to control what side effects you experience, but you can take steps to help manage them. Here are some common side effects and tips for management:

  • Insomnia or trouble sleeping. Going to bed and waking up at the same time every day can help prevent insomnia. It may also help to avoid afternoon caffeine and naps, even if you feel tired.
  • Depression, anxiety, and other changes in mood. A therapist can offer support for these symptoms, whether they relate to the shot or not. Therapy offers a safe space to talk through your feelings and concerns and learn coping strategies to navigate changes in mood.
  • Weight gain. If you’re concerned about weight gain while using the shot, eating a balanced diet and getting regular physical activity can help — but these changes can have benefit no matter what. Taking a more body-neutral approach can also make a difference.
  • Bloating. Staying hydrated, getting regular exercise, and eating enough dietary fiber can all help ease and prevent bloating.

Like all methods of hormonal birth control, the Depo-Provera shot might cause some unwanted side effects, including changes in your:

  • period
  • sleep
  • body weight
  • mood

Keep in mind, though, that not everyone notices these effects.

Many people also consider the shot’s benefits worth the risk of possible side effects. The shot prevents pregnancy very effectively, especially when you get each dose on time.

What’s more, a shot every 3 months may offer a more convenient, lower-maintenance option if you prefer not to take a daily pill and can easily get to your appointments.

Not sure if the shot is right for you? That’s OK — you have plenty of other options. A doctor or clinician can offer more guidance on the best birth control methods for your health history and ongoing needs.


Crystal Raypole writes for Healthline and Psych Central. Her fields of interest include Japanese translation, cooking, natural sciences, sex positivity, and mental health, along with books, books, and more books. In particular, she’s committed to helping decrease stigma around mental health issues. She lives in Washington with her son and a lovably recalcitrant cat.