What happens if you take depo provera for more than 2 years

Depo-Provera (medroxyprogesterone) is an injectable birth control method. The shot is more than 99% effective at preventing pregnancy. When you stop the shots, your fertility should return within 10 months, and you should watch for signs of pregnancy after Depo-Provera is no longer being given. These signs include:

• Missed period
• Nausea
• Fatigue
• Breast tenderness

Many people are satisfied with Depo-Provera. Getting a shot only four times a year is convenient compared to taking the pill every day. It contains progestin, a synthetic progesterone hormone, and does not contain estrogen. You can even start Depo while you are breastfeeding.

This article discusses what to expect when starting Depo-Provera. It also discusses common side effects, and what to expect when you stop using this form of birth control.

Before Starting Depo-Provera

Before you get your first Depo-Provera shot, you will need to be examined by a doctor. Your doctor will also review your health history. This is because Depo-Provera is a hormonal birth control method. Hormonal birth control is not right for everyone.

The manufacturer of Depo-Provera recommends the following tests:

• Blood pressure check
• Breast exam
• Abdominal exam
• Pelvic exam
• Pap smear
• Blood work, if relevant

Starting Depo-Provera

You should get your first Depo-Provera shot during the first five days of your period. This ensures you are not pregnant when you get the shot. If you get the shot at any other time in your cycle, you should get a pregnancy test first.

If you receive your first shot during the first five days of your period, Depo-Provera will provide immediate pregnancy protection. You won't need to use a backup birth control method.

Recap

You will need a medical exam before starting Depo-Provera. You should get your first shot during the first five days of your period. This will ensure immediate pregnancy protection.

Side Effects of Depo-Provera

Before starting Depo-Provera, it is important to discuss potential side effects with your doctor.

Bleeding

Some people have irregular or prolonged bleeding while using Depo-Provera. Others will not have any problems with bleeding.

Spotting and continuous bleeding are the main reasons people stop taking Depo-Provera. People who use Depo-Provera are more likely to stay on it if they are counseled about this potential side effect before receiving their first injection.

There is no way to know ahead of time if you will experience irregular bleeding or spotting. The bleeding may continue until the progestin wears off. This can take up to 11 to 14 weeks after you stop getting the shot.

Research suggests all bleeding stops for about 50% of people who use Depo-Provera continuously for one year. This includes regular monthly bleeding. With continued use, that number rises to 70%.

Bone Density Loss

Depo-Provera may cause bone mineral density loss. This leads to thinning bones and a high risk of bone fractures. Studies have shown that this may reverse when you stop getting Depo-Provera shots.

Try to maintain a healthy lifestyle while you are using Depo-Provera. This can help offset possible calcium loss in your bones.

Make sure you are getting plenty of calcium. Do weight-bearing and muscle-strengthening exercises. Avoid tobacco and drink alcohol in moderation, or not at all.

Weight Gain

Some people gain weight after starting Depo-Provera. Discuss diet and exercise with your doctor before receiving your first shot. Sensible eating and regular exercise may help minimize your weight gain.

Depression

Depression affects approximately 9% of people who use this form of birth control. Talk to your doctor about this possible side effect before starting Depo-Provera.

Recap

Depo-Provera may cause side effects like prolonged bleeding and weight gain. These side effects are reasons why many people stop using Depo-Provera. More serious side effects may also occur.

Stopping Depo-Provera

You can stop using Depo-Provera at any time by simply not getting the next shot.

Because Depo-Provera may cause bone density loss, you should not use it for more than two years. Discuss other birth control options with your doctor at that time.

Getting Pregnant After Depo-Provera

Each Depo-Provera injection lasts about three months. If you decide to get pregnant after stopping Depo-Provera, you will need to plan ahead.

It takes an average of seven to 10 months to regain fertility and begin ovulating after stopping Depo-Provera. Ovulation is when you release an egg each month and are able to become pregnant. Rarely, it can take up to 18 months.

It is possible for fertility to return once your last Depo shot has worn off. For most people, though, getting pregnant after Depo-Provera will take time.

You should stop receiving your Depo injections about one year before you want to become pregnant.

Summary

Depo-Provera is an injectable birth control method. It is taken four times a year. Before starting Depo-Provera, it is important to have a health exam.

Side effects of this form of birth control include weight gain and spotting or prolonged bleeding. These are some of the reasons why people stop using Depo-Provera. In most cases, though, bleeding will stop after one year.

Stop using Depo-Provera one year before you want to become pregnant.

Frequently Asked Questions

• What hormones are in Depo-Provera?

  The Depo-Provera contraceptive injection contains a form of progestin known as medroxyprogesterone.

• When should you get a Depo-Provera shot?

  Depo-Provera is a contraceptive injection that is given every three months. When starting Depo-Provera, you should get the first shot during the first five days of your period.

• Does Depo-Provera stop your period?

  Maybe. Roughly half of all women who use Depo-Provera continuously for a year stop getting their period. However, in some women, Depo-Provera can cause irregular or prolonged bleeding. If you experience continuous spotting or irregular bleeding on the Depo shot, it should resolve 11 to 14 weeks after getting the shot.

• How can you tell if you are pregnant on the Depo shot?

  Depo-Provera can cause missed periods. While it is a highly effective method of contraception, pregnancy rates are still estimated at six out of 100 users per year. If you miss your period and wonder if you are pregnant, taking a pregnancy test is the only way to know for sure. 

  Take a pregnancy test if you experience pregnancy symptoms such as breast tenderness and growth, fatigue, nausea, food aversions, and a frequent need to urinate. If it is positive, call your doctor’s office. 

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.

1. American Academy of Family Physicians. Depo-Provera: An Injectable Contraceptive.

2. Cleveland Clinic. Depo-Provera (birth control shot). Reviewed May 12, 2021.

3. Spevack E. The long-term health implications of Depo-Provera. Integr Med. 2013;12(1):27-34.

4. Singata-Madliki M, Carayon-Lefebvre d'Hellencourt F, Lawrie TA, Balakrishna Y, Hofmeyr GJ. Effects of three contraceptive methods on depression and sexual function: an ancillary study of the ECHO randomized trial. Int J Gynaecol Obstet. 2021;154(2):256-262. doi:10.1002/ijgo.13594

5. Divya V, Gayathri M, Priyadarshini P. DMPA: Compliance and side effects in a tertiary care hospital. Int J Recent Acad Res. 2019;1(6):263-264.

Additional Reading

• Cornet A. Current challenges in contraception in adolescents and young women. Current Opinion in Obstetrics and Gynecology. 2013;25:S1-S10. doi:10.1097/GCO.0b013e32835e06fd

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.

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