Table of ContentsView AllTable of ContentsSymptomsTreatmentWhen to See Your Healthcare Provider
Table of ContentsView All
View All
Table of Contents
Symptoms
Treatment
When to See Your Healthcare Provider
Depo-Provera is an injectable form of birth control that uses a synthetic form of progesterone to prevent pregnancy for up to 14 weeks. One major drawback ofDepo-Proverais the continuous or irregular bleeding (spotting) that can sometimes occurduring the first year.While this typically occurs during the first few months, it can persist for up to a year or longer for some people.
Depo-Provera is discreet and convenient. It is 99% effective when used correctly. However, with typical use, it is only about 94% effective, as some people may forget to get their shots on time.As aprogestin-only contraceptive, it is also a great choice if you are unable to use estrogen-based contraception.
This article explains why Depo-Provera may cause spotting and bleeding, as well as what you can do if it persists.
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Types of Birth Control Shots
Spotting and Bleeding Symptoms
When it comes to birth control, bleeding remains the number one reason why women discontinue contraception.
Depo-Provera can cause:
With a drug like Depo-Provera, vaginal bleeding is not only a common side effect but one that’s expected to occur in about 57% of users in the first year.
Throughout your monthly menstrual cycle, estrogen and progesterone work together to thicken the uterine lining then cause it to shred, resulting in menstrual bleeding. Any imbalance in these hormones can cause spotting. This may happen when you first start Depo-Provera, as it can take a few months for your hormones to adjust.
There is no way to predict who will experience theseside effectsor how severe they might be. For most people, symptoms of bleeding will resolve within a year.On the off chance they don’t, a person may be faced with the choice of either abandoning treatment with Depo-Provera or pushing through.
Additional Symptoms
Other side effects you may experience with Depo-Provera include:
Treatment If Bleeding Continues
For those who continue to have spotting or irregular bleeding, there may be treatments that can help. Most of these are intended only for short-term use and, while effective, come with their own set of side effects and considerations.
Estrogen Supplementation
Research has shown that while estrogen provides short-term relief, the effects generally return when treatment stops.
Lysteda
Lysteda (tranexamic acid) is a non-hormonal oral medication which received Food and Drug Administration (FDA) approval in 2009 for the treatment ofheavy menstrual bleeding.
In one study, 88% of women on Depo-Provera had no vaginal bleeding within one week of treatment compared to 8.2% in the placebo group. After four weeks, a bleeding-free interval of more than 20 days was found in 68% of those treated, and in none of those who took the placebo.
Side effects are relatively mild and include a headache, back pain, stomach ache, sinusitis, muscle and joint pain, migraine, anemia, and fatigue.
Ponstel
Ponstel (mefenamic acid) is a non-steroidal anti-inflammatory drug used for short-term control of spotting and bleeding. It is not considered a long-term solution as prolonged use can increase the risk of high blood pressure, heart attack, and stroke.
Ibuprofen
If any of these treatments are contraindicated or unavailable, some healthcare providers may prescribe a non-steroidal anti-inflammatory drug like ibuprofen taken three times daily to reduce uterine inflammation and alleviate discomfort.
If heavy or prolonged bleeding occurs while taking Depo-Provera, it’s important to remember that the drug may not be the source (or only source) of the condition.
Abnormal bleeding should always warrant a thorough investigation, and all other causes—including uterine fibroids, sexually transmitted infection, and cancer—should be ruled out before a course of treatment is prescribed.
Summary
Depo-Provera is an injectable form of birth control that protects against pregnancy for up to 14 weeks at a time. The shot contains a synthetic form of progesterone, a hormone that, along with estrogen, helps regulate the thickening and shedding of the uterine lining. Any imbalance in these hormones can cause spotting and irregular periods. You may have some spotting for the first few months after starting Depo-Provera, as your body needs time to adjust to the hormone change.
Nonetheless, if you experience abnormal bleeding after getting a Depo-Provera injection, it’s best to see a gynecologist or healthcare provider for evaluation. They’ll check to make sure the bleeding is related to your birth control and not something else.
Frequently Asked QuestionsSpotting or bleeding usually stops within a year of starting Depo-Provera. Treatments do exist to control the bleeding, although most are intended for short-term use. Some examples include estrogen supplementation, Lysteda (tranexamic acid), Ponstel (mefenamic acid), and ibuprofen.If you’re bleeding on Depo-Provera and you receive the shot regularly, the bleeding likely isn’t a result of being pregnant. When used correctly, Depo-Provera is a 99%-effective birth control. If someone forgets to get their shot on time, the effectiveness can drop to 94%.
Frequently Asked Questions
Spotting or bleeding usually stops within a year of starting Depo-Provera. Treatments do exist to control the bleeding, although most are intended for short-term use. Some examples include estrogen supplementation, Lysteda (tranexamic acid), Ponstel (mefenamic acid), and ibuprofen.
If you’re bleeding on Depo-Provera and you receive the shot regularly, the bleeding likely isn’t a result of being pregnant. When used correctly, Depo-Provera is a 99%-effective birth control. If someone forgets to get their shot on time, the effectiveness can drop to 94%.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Food and Drug Administration.Depo-Provera label.NHS Inform.Contraceptive infection.Allen R, Villavicencio J.Unscheduled bleeding and contraceptive choice: increasing satisfaction and continuation rates.OAJC. 2016;7:43–52. doi:10.2147/OAJC.S85565Pfizer Medical Information.DEPO-PROVERA® CI (medroxyprogesterone acetate).Planned Parenthood.What are the disadvantages of the birth control shot?.Planned Parenthood.Are there birth control shot side effects?Senthong AJ, Taneepanichskul S.The effect of tranexamic acid for treatment irregular uterine bleeding secondary to DMPA use.J Med Assoc Thai. 2009;92(4):461‐465.U.S. Food and Drug Administration.PONSTEL (Mefenamic Acid Capsules, USP).Additional ReadingFDA Label.Lysteda (tranexamic acid).
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Food and Drug Administration.Depo-Provera label.NHS Inform.Contraceptive infection.Allen R, Villavicencio J.Unscheduled bleeding and contraceptive choice: increasing satisfaction and continuation rates.OAJC. 2016;7:43–52. doi:10.2147/OAJC.S85565Pfizer Medical Information.DEPO-PROVERA® CI (medroxyprogesterone acetate).Planned Parenthood.What are the disadvantages of the birth control shot?.Planned Parenthood.Are there birth control shot side effects?Senthong AJ, Taneepanichskul S.The effect of tranexamic acid for treatment irregular uterine bleeding secondary to DMPA use.J Med Assoc Thai. 2009;92(4):461‐465.U.S. Food and Drug Administration.PONSTEL (Mefenamic Acid Capsules, USP).Additional ReadingFDA Label.Lysteda (tranexamic acid).
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Food and Drug Administration.Depo-Provera label.NHS Inform.Contraceptive infection.Allen R, Villavicencio J.Unscheduled bleeding and contraceptive choice: increasing satisfaction and continuation rates.OAJC. 2016;7:43–52. doi:10.2147/OAJC.S85565Pfizer Medical Information.DEPO-PROVERA® CI (medroxyprogesterone acetate).Planned Parenthood.What are the disadvantages of the birth control shot?.Planned Parenthood.Are there birth control shot side effects?Senthong AJ, Taneepanichskul S.The effect of tranexamic acid for treatment irregular uterine bleeding secondary to DMPA use.J Med Assoc Thai. 2009;92(4):461‐465.U.S. Food and Drug Administration.PONSTEL (Mefenamic Acid Capsules, USP).
Food and Drug Administration.Depo-Provera label.
NHS Inform.Contraceptive infection.
Allen R, Villavicencio J.Unscheduled bleeding and contraceptive choice: increasing satisfaction and continuation rates.OAJC. 2016;7:43–52. doi:10.2147/OAJC.S85565
Pfizer Medical Information.DEPO-PROVERA® CI (medroxyprogesterone acetate).
Planned Parenthood.What are the disadvantages of the birth control shot?.
Planned Parenthood.Are there birth control shot side effects?
Senthong AJ, Taneepanichskul S.The effect of tranexamic acid for treatment irregular uterine bleeding secondary to DMPA use.J Med Assoc Thai. 2009;92(4):461‐465.
U.S. Food and Drug Administration.PONSTEL (Mefenamic Acid Capsules, USP).
FDA Label.Lysteda (tranexamic acid).
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