Medroxyprogesterone acetate is the progestogen in the contraceptive injection given every few months, sold under brand names including Depo-Provera. It is highly effective and requires nothing between appointments.
The feature that distinguishes it from every other method: once an injection has been given it cannot be removed or reversed. If side effects occur, they continue until the dose wears off. That is worth understanding before the first injection rather than after, and it is a reasonable argument for trying a reversible method first if you are uncertain.
Common hormonal medicine side effects
- Changes to bleeding, the most common effect. Irregular or prolonged bleeding at first, with periods often becoming lighter or stopping with continued use.
- Weight gain
- Headaches
- Mood changes
- Breast tenderness
- Abdominal discomfort or bloating
- Reduced sexual desire
Containing no oestrogen, it can generally be used by people who cannot take combined pills.
Bleeding, mood, skin, weight and cycle changes
Periods stopping altogether is common with continued use and is not harmful. For some people that is the main attraction of the method.
Weight gain is reported more consistently with injectable contraception than with most other methods, so tracking it from the start is worthwhile. See contraceptive injection and weight gain.
Return of fertility can be delayed after stopping, sometimes by several months beyond the point the injection stops working. This is temporary and does not mean lasting infertility, but it matters if you may want to conceive within the next year. See fertility after the contraceptive injection.
Bone density can reduce with prolonged use and generally recovers after stopping. Long-term use is usually reviewed periodically for this reason, particularly in younger people who have not reached peak bone mass. See long-term injection side effects.
Serious warning signs that need medical attention
- Very heavy or prolonged bleeding, or bleeding causing dizziness or breathlessness
- Severe abdominal pain
- Signs of infection at the injection site: increasing pain, redness, swelling or discharge
- Severe or persistent low mood, or thoughts of self-harm
- Yellowing of the eyes or skin
- A severe headache unlike your usual, or sudden vision changes
Who may be at higher risk?
Tell your clinician about unexplained vaginal bleeding, liver conditions, a history of breast cancer, significant risk factors for bone thinning, a history of depression, or plans to become pregnant within the next year.
It does not protect against sexually transmitted infections.
What to discuss with your doctor, pharmacist or clinic
- When is my next injection due, and how late can I be?
- What happens if the bleeding pattern does not settle?
- How long before fertility returns if I stop?
- Should long-term use be reviewed given bone density?
- Would a method I can stop at any time suit me better?
Related contraception, HRT and hormonal medicine guides
- Hormonal medicine side effects
- Women’s health and hormonal medicine side effects
- Hormonal contraception side effects
- When to see a doctor about hormonal medicine
- Report a hormonal medicine side effect
See also Depo-Provera, Nur-Isterate and contraceptive injection side effects.
Medical Disclaimer: This content is for informational and educational purposes only and does not constitute medical diagnosis, prescription, or professional advice. Always read the patient information leaflet and consult a qualified doctor or pharmacist regarding any medicine or health concern.