Depo-Provera is a contraceptive shot used by millions of women since it was approved by the FDA two decades ago: Your gyno gives you a jab (usually to your upper arm) once every three months, and it has a 99.7 percent effectiveness rate at keeping you baby-free. That’s as good as the pill, without the added stress of remembering to take it every day.
But as a new report from the journal Integrative Medicine points out, studies link Depo-Provera to a greater risk of bone fractures, fertility issues, and even HIV. If you currently rely on Depo or you’re considering going on it, here’s what you need to know.
The side effects might be rougher
Depo-Provera is a progestin-only BC; this artificial hormone puts the brakes on baby-making by blocking ovulation and thickening cervical mucus. But because Depo contains more progestin than other progestin-only varieties (such as the Mirena IUD and the mini-pill), users report more fatigue, weight gain, irregular periods, and other mental and physical side effects, according to the article in Integrative Medicine. That being said, not every woman who takes it deals with hormonal hell. In fact, some actually feel better on Depo.
“Many of my patients say that their PMS symptoms go away,” says Mary Jane Minkin, MD, clinical professor of ob-gyn at Yale University School of Medicine. Talking to your doctor beforehand can help you suss out how Depo might affect you.
Your fertility takes time to rebound
Hoping to get pregnant in the not-so-distant future? Depo-Provera might mess with your plans. After you stop getting the shots, it can take up to nine months for your fertility to fully return, thanks to the long-lasting hormone dosage Depo delivers to your bloodstream, Minkin says. So if you think you might want to get pregnant before then, go with another birth control method.
It can weaken your bones
Osteoporosis probably isn’t on your radar right now, but it’s something women who take Depo may have to consider. Studies show that Depo-Provera reduces bone mineral density, potentially setting users up for an increase in fractures and even this dreaded brittle-bone disease later in life. In light of this, the FDA mandates a warning on the drug’s label stating that the longer a woman takes Depo, the weaker her bone density may be. The jury is still out, however, on whether this bone loss is reversible. Some research has shown that once a woman quits Depo, her bone health returns to normal, Minkin says. To play it safe, the FDA advises not taking Depo for more than two continuous years.
The link to HIV is questionable
A 2011 study found that Depo-Provera doubled the risk of transmitting and contracting HIV. But hold on—because the study only looked at Sub-Saharan African women who either had HIV or whose partner carried the virus, and since it’s not clear if the association is due to Depo itself or the study participants’ behavior, the results aren’t reliable, Minkin says. “Like all hormonal birth control methods, Depo-Provera does not protect against STDs and HIV—so condoms are a must.”
More from Women’s Health:
Spotlight: Birth Control
Birth Control Side Effects: The Positives to Being on the Pill
Your Doctor’s Favorite Birth Control Method
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