6 Common Depo-Provera Side Effects

What to Expect and What You Can Do

Common Side Effects of Depo-Provera
Verywell / Emily Roberts

Depo-Provera is an injectable form of hormonal birth control which uses progestin (a synthetic form of progesterone) to prevent pregnancy. Depo-Provera is not only discreet and convenient but is as much as 99.7% effective when used correctly. As a ​progestin-only contraceptive, it may be a great choice if you are unable to use estrogen-based contraception.

Depo-Provera side effects may occur as your body adjusts to the effects of the medication. Some are women affected more than others, and some may not experience any symptoms at all. The most common side effect of Depo-Provera include:


Irregular Menstrual Bleeding

Many women stop using Depo-Provera due to prolonged spotting or bleeding, often within the first year of treatment. These side effects are common and can persist in some women for more than a year.

Sadly, there is no way to predict who will experience bleeding or how severe the symptoms may be. In some cases, termination of treatment is the only option.

For others, estrogen supplementation, Lysteda (tranexamic acid), and Ponstel (mefenamic acid) may provide short-term relief until the body better normalizes to the effects of the drug.


Termination of Periods

After a few shots, Depo-Provera will usually stop menstruation. When this happens, it may either make your periods very light or terminate them altogether.

Clinical studies estimate that over a third of women on Depo-Provera will experience amenorrhea (the absence of menstruation) by month six. After a year, that number will increase to 55% and continue to increase to 68% by year two.

Many women, in fact, are willing to tolerate the initial bleeding in exchange for the chance of not having to have a period anymore.


Bone Density Loss

Depo-Provera contains a black box warning about the possibility of progressive bone loss. According to the U.S. Food and Drug Administration (FDA), if Depo-Provera is used continuously for more than two years, the loss of calcium may significantly increase the risk of osteoporosis and broken bones.

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

To mitigate bone loss, doctors will often recommend calcium and Vitamin D supplements along with a calcium-rich diet. It is important to remember that if a bone loss occurs, it is considered permanent and will not return.


Weight Gain

Weight gain is another common reason why women will stop using Depo-Provera. 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, year on year, by an additional 4 pounds. By year six, women on Depo-Provera gain an average of 16.5 pounds (or roughly 2.9 pounds per year).

This effect, however, is not seen in all women. Regular exercise and a calorie- and fat-restricted diet can often mitigate the risk.


Delayed Return of Fertility

Depo-Provera has a prolonged contraceptive effect. Once stopped, it may take up to a year to regain fertility and start ovulating normally again. If you decide to get pregnant, you would likely have to wait for at least nine to 10 months before trying.

According to post-market research, it took 68% of women 12 months to get pregnant after stopping Depo-Provera. By 15 months, the overall figure increased to 83%. By 18 months, a total of 93% of women who wanted to get pregnant were able to do so.


Local Injection Reactions

One of the more common, and perhaps least worrisome, symptoms of Depo-Provera are local reactions to the shot. Some women will report mild pain associated with the injection, while 6% will experience skin reactions around the area where the shot was delivered. Both tend to be relatively minor and will resolve on their own within a day or two.

Other common systemic side effects include:

  • Abdominal pain or discomfort
  • Dizziness
  • Headache
  • Weakness or fatigue
  • Nervousness

For the most part, these types of symptoms improve the longer you take Depo-Provera and usually don't need treatment.

Frequently Asked Questions

  • How long do side effects usually last from Depo Provera?

    Most side effects from Depo Provera subside within two to three months.

  • Can hormonal birth control make you tired?

    It is possible that hormonal birth control can cause fatigue. One study published in 2020 showed a link between hormonal contraceptive use, insomnia symptoms, and daytime sleepiness.

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Article Sources
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