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"The shot" is an injectable progestin-only prescription method of reversible birth control. It contains a hormone that is similar to the progesterone made by a woman's ovaries to regulate the menstrual cycle. The shot is also known as DMPA. The D stands for "depot," the solution in which the hormone is suspended. The hormone is medroxyprogesterone acetate. The common brand name for the DMPA shot is Depo-Provera. A shot of DMPA can prevent pregnancy for 12 weeks. It
- usually, prevents the ovaries from releasing an egg (ovulation)
- less often, thickens cervical mucus to prevent sperm from joining an egg
- alters the lining of the uterus, which, in theory, may prevent implantation of a fertilized egg
EffectivenessThe shot is one of the most effective reversible methods of birth control. Of every 1,000 women who use it correctly and consistently, only three will become pregnant during the first year of use. Three in 100 women will become pregnant with typical use.
Protection is immediate if you take the shot during the first five days of your period. Otherwise, use a backup method of contraception for the first week. Protection lasts for 12 weeks.
The shot is not effective against sexually transmitted infections. Use a latex or female condom to reduce the risk.
Advantages & DisadvantagesAdvantages
- can be used by women who cannot take estrogen
- can be used while breastfeeding
- effective for 12 weeks
- helps prevent cancer of the lining of the uterus
- no pill to take daily
- nothing to put in place before vaginal intercourse
Disadvantages
- must receive shot every three months
- pregnancies, which very rarely occur, are more likely to be ectopic (in a fallopian tube)
- may not be used continuously for more than two years unless no other method is right for you
- takes an average of nine to 10 months ? or sometimes more than a year ? to get pregnant after getting the last shot
Possible Side EffectsIrregular bleeding is the most common side effect for women using DMPA. It is more common in the first six to 12 months of use.
- Periods become fewer and lighter for most women, and often stop altogether. The longer a woman uses the shot, the more likely her periods will stop. It may take up to a year for periods to return after a woman's last shot.
- Some women will have longer, heavier periods.
- Some may have increased light spotting and breakthrough bleeding.
Women who use DMPA may have temporary bone thinning
Less Common Side Effects
- change in sex drive
- change of appetite, weight gain
- depression
- hair loss, or increased hair on the face or body
- headache
- nausea
- nervousness, dizziness
- skin rash or spotty darkening of the skin
- sore breasts
There is no way to stop the side effects of the shot ? they may continue until it wears off (12?14 weeks).
Warning Signs
Serious problems are rare. Tell your clinician immediately if you have
- a new lump in your breast
- major depression
- severe pain in the stomach or abdomen
- unusually heavy or prolonged vaginal bleeding
- yellowing of skin or eyes
Who Can Use the Shot?Most women can use the shot.
It may be especially appropriate if you
- want very effective long-lasting contraception
- cannot take estrogen
- are unable to use barrier methods routinely or take a daily pill
Usually women who use the shot need special medical supervision if they have
- current serious blood clotting conditions
- high blood pressure
- high risk for heart disease
- a history of severe depression
- liver disease, such as hepatitis, abnormal results on liver function tests, or a history of liver tumors
You should not use the shot if you
- cannot put up with irregular bleeding or loss of your period
- are taking medicine for Cushing's syndrome
- are or might be pregnant
- have a known or suspected breast cancer
- have unexplained bleeding from the vagina
- want to become pregnant within the next year
Women should not use the shot continuously for more than two years unless no other method is right for them.
- Women who use DMPA may have temporary bone thinning. It increases the longer they use DMPA. Bone growth begins again when women stop using the shot. Whether or not there is a complete recovery of bone mass is unknown.
- Whether or not temporary bone thinning leads to greater risk of bone fracture from osteoporosis much later in life is also unknown.
To protect your bones, get regular exercise and get extra calcium and vitamin D ? either through your diet or by using supplements.
How to Get the ShotYour clinician will take your medical history. Depending on your medical history, you may need a partial or complete physical exam.
Your clinician will give you an injection ? you may have a temporary bruise.
You will need an injection every 12 weeks for as long as you want to prevent pregnancy.
The CostNationwide, the cost for an exam, if needed, ranges from $35 to $125. Further visits cost between $20 and $40. Each injection costs between $30 and $75. The total cost for each year of use ranges from $235 to $585. Costs vary from community to community, based on regional and local expenses. Medicaid may cover these costs. Private health insurance coverage for birth control varies. Family planning clinics usually charge less than private health care providers.
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