9 Common Depo-Provera Side Effects

What to know before starting the birth control shot

The Depo-Provera shot may cause side effects such as spotting or bleeding between periods, the absence of periods, and weight gain. These usually happen as your body gets used to the medication. More serious side effects, such as bone loss, can also occur with use.

Depo-Provera is an injection that is given every 12 weeks. When used correctly, it is as much as 99.7% effective. As a ​progestin-only birth control, it may be a great choice if you are unable to use estrogen-based birth control.

Read on to learn more about common Depo side effects that you should consider before starting the shot, as well as those you should bring to your healthcare provider's attention if you already take it.

Common Side Effects of Depo-Provera
Verywell / Emily Roberts

Irregular Menstrual Bleeding

Menstrual cycle changes are the most common side effects of the Depo-Provera shot. Many individuals stop using it within the first year because of irregular spotting or bleeding. This side effect can last more than a year for some people.

There is no way to predict who will experience this Depo shot side effect or how severe it may be. In some cases, ending the treatment is the only option.

For others, supplementation like Lysteda (tranexamic acid) and Ponstel (mefenamic acid) may provide short-term relief until the body gets used to Depo-Provera.

No Periods

After a few shots, Depo-Provera may stop menstruation altogether in some people. Others may have very light periods. This is often considered a positive side effect of the Depo shot.

Clinical studies estimate that over a third of those on Depo-Provera will stop menstruating after six months of treatment. This number increases to 55% of individuals after a year and 68% by year two.

Many are willing to tolerate the initial bleeding with the hopes of not having a period anymore.

Anxiety and Mood Changes

Some people have reported mood changes, depression, and anxiety while using Depo-Provera, but the evidence that the shot causes these side effects is inconsistent.

In clinical trials, nervousness was reported by 10.8% of those using Depo-Provera, and depression was reported by 1.5%. 

If you have a history of depression, you should be monitored for mood-related side effects while using Depo-Provera. If you experience symptoms of depression, discontinue use.

Bone Density Loss

According to the Food and Drug Administration, if Depo-Provera is used continuously for more than two years, individuals are more prone to bone thinning, also known as osteoporosis, and broken bones.

Because of the risk of bone loss, it is recommended that individuals should limit their use of Depo-Provera to no more than two years.

To help with bone loss, healthcare providers often recommend calcium and vitamin D supplements, as well as a calcium-rich diet. Keep in mind that if bone loss occurs, it is considered permanent.

Depo-Provera has a black box warning, which is a label used to highlight serious medication risks, regarding this side effect.

Weight Gain

Weight gain is another possible Depo shot side effect and a reason why some stop using it. According to research, around two-thirds of women who used Depo-Provera reported a weight gain of 5 pounds during the first year.

That number increased to 8 pounds by year two and continued to increase. By year six, women on Depo-Provera gained an average of 16.5 pounds (or roughly 2.9 pounds per year).

This side effect is not seen in everyone, however.

Delayed Fertility

Depo-Provera has a long-lasting birth control effect. Once stopped, it may take up to a year to start ovulating normally again.

If you would like to get pregnant, you may have to wait at least nine months before trying.

According to research, 68% of women were able to get pregnant within 12 months after stopping Depo-Provera. By 15 months, this increased to 83%. By 18 months, 93% of those who wanted to get pregnant were able to do so.

Abdominal Pain

During clinical trials, abdominal pain or discomfort was reported by 11.2% of those using Depo-Provera.

This can be a sign of ectopic pregnancy—a pregnancy that occurs outside of the uterus—which has been reported in some people who use Depo-Provera.

If you have severe abdominal pain while using this form of birth control, seek emergency care at once. Ectopic pregnancy is a life-threatening emergency.

Headache

Some people taking Depo-Provera experience headaches. During clinical trials, this side effect was reported by 16.5% of subjects.

Local Injection Reactions

One of the more common Depo shot side effects is a reaction to the injection. Some report mild pain associated with the shot, while others experience skin reactions around the area where the shot was given.

These reactions tend to be relatively minor and resolve on their own within a day or two.

Other possible side effects of Depo-Provera include:

  • Dizziness
  • Weakness or fatigue

These types of symptoms tend to get better the longer you take Depo-Provera and usually don't need treatment.

Summary

Depo-Provera is a progestin-based birth control shot. Common side effects include irregular or no periods, bone thinning, weight gain, delayed ovulation, injection site reactions, and depression. Some may also experience headaches, dizziness, and fatigue. Be sure to discuss any concerns with your doctor.

Frequently Asked Questions

  • How long do Depo shot side effects usually last?

    Most side effects from Depo-Provera go away within two to three months.

  • Is the Depo shot safe?

    Depo-Provera is safe for most people. However, people with liver disease, heart disease or stroke, lupus, or breast cancer should avoid using it.

  • Can hormonal birth control make you tired?

    Hormonal birth control may cause fatigue. One study showed a link between hormonal birth control use, insomnia symptoms, and daytime sleepiness.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Veisi F, Zangeneh M. Comparison of two different injectable contraceptive methods: depo-medroxy progesterone acetate (DMPA) and Cyclofem. J Family Reprod Health. 2013;7(3):109-13.

  3. FDA label. Depo-Provera.

  4. Dianat S, Fox E, Ahrens KA, et al. Side effects and health benefits of depot medroxyprogesterone acetate: a systematic review. Obstet Gynecol. 2019;133(2):332-41. doi:10.1097/AOG.0000000000003089

  5. Planned Parenthood. What are the disadvantages of the birth control shot?

By Dawn Stacey, PhD, LMHC
Dawn Stacey, PhD, LMHC, is a published author, college professor, and mental health consultant with over 15 years of counseling experience.