Must Knows About Starting and Stopping Depo Provera
Updated August 05, 2015.
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
Depo Provera is a very effective birth control method. Before starting Depo Provera, it is important that you are aware of common depo side effects as well as the importance of receiving your depo injections on time. Many women are not aware that getting pregnant after Depo Provera may take awhile. Just as important as knowing where and how to get this birth control shot, it's also helpful to be aware of what to expect after stopping Depo Provera.
Starting Depo Provera:
In order to receive your first Depo Provera shot, you will most likely need a physical examination as well as review your complete health history with your doctor. Pfizer, the manufacturer of Depo Provera and Depo-subQ Provera 104 recommends that all women wishing to start Depo Provera should have a physical examination that includes a blood pressure check, examination of the breasts, abdomen, and pelvic organs, pap smear, and any relevant laboratory studies.
Before You Start Depo Provera:
It is important to discuss the following information with your doctor before starting Depo Provera:
- There is the potential for irregular or prolonged bleeding while using Depo Provera -- there is no way to know before starting Depo Provera if you will experience this side effect. It is important that you realize that this bleeding may continue until the progestin from the depo shot wears off (which can take 11 to 14 weeks) you may just have some irregular spotting, or you may not have any bleeding issues at all. Spotting/continous bleeding is the main reason women report for stopping Depo Provera. Research shows that all bleeding (including having a monthly period) typically stops for around 50% of women who use Depo Provera continuously for one year. It has been shown that women are more likely to continue using Depo Provera if they are counseled about these bleeding side effects before they receiving their first depo injection.
- Depo Provera has a blackbox warning that its use may cause bone mineral density loss. To help offset this possible calcium loss to your bones, it is important that you maintain a healthy lifestyle, including adequate calcium intake, weight-bearing and muscle strengthening exercises, no smoking, and moderate to no alcohol while using Depo Provera.
- It is not uncommon for bodyweight and fat to increase after starting Depo Provera. Because of this, make sure to discuss with your doctor a possible exercise and/or diet plan. Sensible eating and frequent exercise may help to minimize weight gain while using this contraceptive method.
When to Get the Depo Provera Shot:
You should get your first Depo Provera shot during the first five days of your period to make sure that you are not pregnant. If you get the depo shot at any other time in your cycle, you should have a pregnancy test done to rule out pregnancy before starting Depo Provera. If you receive your first injection during the first five days of your period, Depo Provera will provide immediate pregnancy protection, so you will not need to use a back-up birth control method.
Stopping Depo Provera:
You can stop using Depo Provera at anytime by choosing not to have your next scheduled injection. It is also suggested that you should be stopping Depo Provera use after you have been receiving injections for two years. Because of bone density loss potential, using depo for more than two years should be carefully weighed against other available contraceptive options.
Getting Pregnant After Depo Provera:
Keep in mind that each Depo Provera injection lasts about three months, so you will need to plan ahead if you want to get pregnant after stopping Depo Provera. It takes an average if 9 to 10 months (and sometimes more than a year) to regain fertility and begin ovulating after stopping Depo Provera. So, you should stop receiving your depo injections about one year before you want to become pregnant. Although it is possible for fertility to return once your last depo shot has worn off, getting pregnant after Depo Provera use will most likely take a long time.
Being aware of these depo issues prior to starting Depo Provera may help increase your success with this method. Many women report being satisfied with their depo use. They love the no-hassle nature of only needing to get depo injections four times a year (as compared to taking the pill every day) and appreciate that it does not contain any estrogen. You can even start depo use while you are breastfeeding. That being said, some of the side effects, like bleeding and weight gain, are reasons why many women report stopping Depo Provera use. Being prepared and knowing what to potentially expect can help you to decide if Depo Provera is the right contraceptive method for you.
Sources:
Cornet, A. "Current challenges in contraception in adolescents and young women."Current Opinion in Obstetrics and Gynecology. 2013; 25:S1-S10. Accessed via private subscription.
Westhoff, C. "Depot-medroxyprogesterone acetate injection (Depo-Provera®): A highly effective contraceptive option with proven long-term safety."Contraception. 2003; 68(2):75-87. Accessed via private subscription.
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