What You Really Need to Know About the Depo Shot

Holy Hormones Journal: I found this pretty mainstream article – okay – very mainstream article about the Depo shot; aka the birth control shot; aka the birth control vaccine. The author has provided some information that I was not aware of – and she concludes her article with the importance of micronutrients/vitamins in the diet to control not only weight – but as I often recommend withdrawal side effects.

Since I hear from so many women struggling on Depo – see article and comments here – “Depo Provera Withdrawal – A Woman’s Worst Nightmare,” I have taken the time to compile credible links where I get my information to respond to the hundreds of women who struggle on Depo and coming off of Depo.

But how much do we know about this vaccine?  How much doe we know about the long-term effects? What we do know is the Depo is used as a castration tool for male sex offenders in prison. LB

The rest of the articles – the links and the information you should really know before you opt in for the Depo shot is below the article. Hoping that all of the information provided by the author and myself will help with informed consent.

The one article I could not find – one of the links that I had kept was not longer valid – but I remembered the information – was that Depo was designed for women ages 18 and above. Not for adolescents. But since I cannot back it up – you have to make your own decision. However, of real concern is that adolescents on Depo lost bone mineral density (BMD) at a time – puberty – when they are building BMD. That information is below.

Other information that I included and that is highlighted in black below is that it is not recommended that Depo be used longer than two years – unless all other forms of birth control have been ruled out. So many women have been on this drug for longer than that – I think one woman just posted she had been on it 20 years.

6 Things You Should Know About the Birth Control Shot

The truth about weight gain, hormones, and fertility on Depo-Provera




There are more birth control options available to you than ever. You can get intrauterine devices (IUDs), insert rings, use condoms, get an implant, slap on a patch, or pop a pill. And a recent survey done by the Guttmacher Institute found that 99 percent of women have used at least one of these during their sexually active years. But there’s one form of birth control that most women don’t think of: the shot. Only 4.5 percent of women choose to use injectable contraceptives, even though they’re listed as one of the most reliable and cost-effective methods.

That’s why we talked to Alyssa Dweck, M.D., OBGYN, and co-author of V is for Vagina, to get the real scoop on its safety, comfort, and efficacy. Here are six things you need to know about the shot, so you can make the best decision for your body:

It works. The Depo-Provera shot is 99 percent effective at preventing pregnancy, meaning it’s as good as intrauterine devices (IUDs) like the Mirena and better than using the pill (98 percent effective) or condoms (85 percent effective). “It’s very reliable since it doesn’t require daily administration, so there’s less chance for human error,” says Dweck. (Psst…Check out these 6 IUD myths, busted!)

It’s long-term (but not permanent) birth control. You need to get a shot every three months for continuous birth control, which amounts to a quick trip to the doctor four times a year. But if you decide you’re ready for a baby, your fertility is restored after the shot wears off. Note: It takes an average of 10 months after your last shot to get pregnant, longer than other hormonal types of birth control, like the pill. This makes it a good choice for women who know they want kids someday but just not in the near future.

It uses hormones. Currently, there’s only one type of injectable contraception, called Depo-Provera or DMPA. It’s an injectable progestin—a synthetic form of the female hormone progesterone. “It works by inhibiting ovulation and preventing egg release, thickening cervical mucus, which makes it harder for sperm to access an egg for fertilization, and by thinning the uterine lining making the uterus inhospitable for pregnancy,” says Dweck.

There are two dosages. You can choose to get either 104 mg injected under your skin or 150 mg injected into your muscle. Some studies suggest that our bodies absorb medicine better from intramuscular injections but that method may also be slightly more painful. Nevertheless, both methods provide extremely effective protection.

Read full article…


Holy Hormones Journal Depo Sources

How Effective Is Depo-Provera for Birth Control? – Web MD

Depo-Provera is a contraceptive method for women. It’s made of a hormone similar to progesterone.

Depo is made of a synthetic progesterone – called “progestin.” “Similar” is not even close to the “same.” Depo suppresses progesterone which may be a primary factor in why so many women struggle with this method of birth control. Progesterone is a primary hormone not just for reproduction but for mood stabilization and most importantly off-setting the effects of xenoestrogens in our environment. Many of us are estrogen dominant to begin with – meaning that we have low levels of progesterone. Suppressing what is left wreaks havoc on our body. LB

It’s OK for most women. But it’s not recommended for those who have:

It should be used with caution in teens, and by women withosteoporosis because of its relation to bone loss.

What Are the Side Effects?

They can include:

Contraceptive Injection
medroxyprogesterone acetate injectable suspension, USP

Physician Information – Daily Med – NIH/gov


  1. Known or suspected pregnancy or as a diagnostic test for pregnancy.
  2. Undiagnosed vaginal bleeding.
  3. Known or suspected malignancy of breast.
  4. Active thrombophlebitis, or current or past history of thromboembolic disorders, or cerebral vascular disease.
  5. Significant liver disease.
  6. Known hypersensitivity to DEPO-PROVERA CI (medroxyprogesterone acetate or any of its other ingredients).

BMD* Changes in Adolescent Females (12–18 years of age)

Preliminary results from an ongoing, open-label, self-selected, non-randomized clinical study of adolescent females (12–18 years) also showed that Depo-Provera CI use was associated with a significant decline in BMD from baseline (Table 3). In general, adolescents increase bone density during the period of growth following menarche, as seen in the untreated cohort. However, the two cohorts were not matched at baseline for age, gynecologic age, race, BMD and other factors that influence the rate of acquisition of bone mineral density, with the result that they differed with respect to these demographic factors.

Preliminary data from the small number of adolescents participating in the 2-year post-use observation period demonstrated partial recovery of BMD.

*Bone Mineral Density

When you read through the ingredient list for Depo – one of the components is Polysorbate 80 also known as Tween 80 and polyoxyethylene-sorbitan-20 mono-oleate.  Polysorbate 80 “may cause cancer based on animal test data” and may be mutagenic. It is an emulsifier that has been shown to cause infertility in lab mice. Poly 80 is also in the Gardasil HPV vaccine and is found in small amounts in ice cream and other products.  – LB

Depot medroxyprogesterone acetate – Wikipedia

The WHO Medical Eligibility Criteria for Contraceptive Use and RCOG Faculty of Family Planning & Reproductive Health Care (FFPRHC) UK Medical Eligibility Criteria for Contraceptive Use list the following as conditions where use of Depo-Provera is not usually recommended or should not be used because of an unacceptable health risk or because it is not indicated:[23][24]

Conditions where the theoretical or proven risks usually outweigh the advantages of using Depo-Provera:

Conditions which represent an unacceptable health risk if Depo-Provera is used:

  • Current or recent breast cancer (a hormonally sensitive tumour)

Conditions where use of Depo-Provera is not indicated and should not be initiated:

Side effects

Warnings and precautions

  • Takes one week to take effect if given after the first five days of the period cycle. Effective immediately if given during the first five days of the period cycle.
  • Offers no protection against sexually transmitted diseases (STDs).
  • Depo-Provera can affect menstrual bleeding. After a year of use, 55% of women experience amenorrhoea (missed periods); after 2 years, the rate rises to 68%. In the first months of use “irregular or unpredictable bleeding or spotting, or, rarely, heavy or continuous bleeding” was reported.
  • Delayed return of fertility. The average return to fertility is 9 to 10 months after the last injection. By 18 months after the last injection, fertility is the same as that in former users of other contraceptive methods
  • Long-term studies of users of Depo-Provera have found slight or no increased overall risk of breast cancer. However, the study population did show a slightly increased risk of breast cancer in recent users (Depo use in the last four years) under age 35, similar to that seen with the use of combined oral contraceptive pills.
  • A study of accidental pregnancies among poor women in Thailand found that infants who had been exposed to Depo-Provera during pregnancy had a higher risk of low birth weight and an 80% greater-than-usual chance of dying in the first year of life.

Black box warning

On November 17, 2004 the United States Food and Drug Administration put a black box warning on the label, indicating that there were potential adverse effects of loss of bone mineral density. While it causes temporary bone loss, most women regain their bone density after discontinuing use. The World Health Organization (WHO) recommends that the use not be restricted. The American College of Obstetricians and Gynecologists notes that the potential adverse effects on BMD be balanced against the known negative effects of unintended pregnancy using other birth control methods or no method, particularly among adolescents.

Three studies have suggested that bone loss is reversible after the discontinuation of Depo-Provera. Other studies have suggested that the effect of Depo-Provera use on post-menopausal bone density is minimal, perhaps because Depo users experience less bone loss at menopause. Use after peak bone mass is associated with increased bone turnover but no decrease in bone mineral density.

The FDA recommends that Depo-Provera not be used for longer than 2 years, unless there is no viable alternative method of contraception, due to concerns over bone loss. However, a 2008 Committee Opinion from the American Congress of Obstetricians and Gynecologists (ACOG) advises healthcare providers that concerns about bone mineral density loss should neither prevent the prescription of or continuation of Depo-Provera beyond 2 years of use.

Cervical cancer in Upjohn/NCI studies. Cervical cancer was found to be increased as high as 9-fold in the first human studies recorded by the manufacturer and the National Cancer Institute. However, numerous larger subsequent studies have shown that Depo-Provera use does not increase the risk of cervical cancer.

This probably means that the studies were re-done to get the outcome needed and to play down the cervical cancer risk. ~ LB


Treatment of sex offenders with Depo-Provera.


Medroxyprogesterone acetate (MPA) is capable of reducing male testosterone blood levels with a corresponding reduction in sexual interest and activity. An attempt to evaluate its effectiveness with court committed sexual offenders was made with eight subjects each serving as his own control by alternating Depo-Provera injections for 16 weeks with saline injections for a corresponding 16 weeks. This paper reports the results of this study and the conclusions that appear to be appropriate.

Depo-Provera – Drugs.com


Generic Name: medroxyprogesterone acetate
Dosage Form: injection, suspension


  1. Active thrombophlebitis, or current or past history of thromboembolic disorders, or cerebral vascular disease
  2. Known sensitivity to Depo-Provera (medroxyprogesterone acetate or any of its other ingredients).


1. Thromboembolic Disorders

The physician should be alert to the earliest manifestations of thrombotic disorder (thrombophlebitis, cerebrovascular disorder, pulmonary embolism, and retinal thrombosis). Should any of these occur or be suspected, the drug should be discontinued immediately.

2. Ocular Disorders

Medication should be discontinued pending examination if there is a sudden partial or complete loss of vision, or if there is a sudden onset of proptosis, diplopia or migraine. If examination reveals papilledema or retinal vascular lesions, medication should be withdrawn.

3. Multi-dose Use

Multi-dose use of Depo-Provera Sterile Aqueous Suspension from a single vial requires special care to avoid contamination. Although initially sterile, any multi-dose use of vials may lead to contamination unless strict aseptic technique is observed.


Author: Leslie Carol Botha

Author, publisher, radio talk show host and internationally recognized expert on women's hormone cycles. Social/political activist on Gardasil the HPV vaccine for adolescent girls. Co-author of "Understanding Your Mood, Mind and Hormone Cycle." Honorary advisory board member for the Foundation for the Study of Cycles and member of the Society for Menstrual Cycle Research.