What is the Depo-Provera birth control shot?
Two "birth control shots," or injectables, are available to women. One of them, Depo-Provera, is administered once every three months. It provides a hormone much like the progesterone a woman produces during the last two weeks of each monthly cycle. It stops the woman from releasing an egg and provides other contraceptive effects. Many clinics recommend that you use a backup contraceptive for a week after your first shot. Among typical couples who use Depo-Provera, about three in 1,000 will experience an accidental pregnancy in the first year. Complete information about this contraceptive is available from your clinician or from the package insert that is provided when you are given Depo-Provera injections.

What are the advantages?

• No birth control method must be taken daily or used at the time of sexual intercourse.

• Depo-Provera is extremely effective. If women receive their injections right on time (every three months or 13 weeks), only three women in 1,000 will become pregnant in the course of one year.

• Women lose less blood using Depo-Provera and have less menstrual cramping. Often after three injections, women stop having periods. This is safe!

• Privacy is a major advantage. No one has to know you are using this method.

• Nursing mothers can receive Depo-Provera injections. According to the World Health Organization, it's best to begin use after the baby is six weeks old, but most U.S. programs will provide Depo-Provera when a nursing mother leaves the hospital after delivery.

• It's OK to start a new contraceptive if fewer than 13 weeks have passed since the last shot.

• Depo-Provera may improve premenstrual syndrome (PMS), depression and symptoms from endometriosis.

• Depo-Provera can prevent ectopic pregnancies.

• Unlike combined pills, Depo-Provera is not less effective if you take medicines that affect the liver.

What are the disadvantages?

• Depo-Provera injections can lead to very irregular periods. If your bleeding pattern is bothersome to you, you can take medications that may give you a more acceptable pattern of bleeding.

• Some women gain weight. To avoid weight gain, watch your calories and get lots of exercise.

• Depo-Provera does not protect you from HIV or other infections. Use condoms if you are at risk.

• You must return to the clinic every three months for your injection.

• Depression and premenstrual symptoms may become worse.

• It may be a number of months before your periods return to normal after your last shot. It takes an average of 10 months for fertility to return after the last shot, making it hard to plan pregnancy exactly.

• Depo-Provera may lower your estrogen level and cause bone loss, although this is not certain. Get regular exercise and take extra calcium to protect your bones from osteoporosis.

• A few women are allergic to Depo-Provera. Fortunately, allergic reactions are very rare, but they occur, and the effects of the shot cannot be stopped once it is given. Such a woman may need anti-allergy medicine for several days to months.

• Depo-Provera is expensive in some health-care settings.

• In some studies there was an increase in LDL (bad cholesterol) and a decrease in HDL (good cholesterol).

Where can I go to get started using Depo-Provera shots?
You can get Depo-Provera injections from your clinician, health department or family planning clinic. Most clinics provide the first shot when a woman has her period or within seven days after the start of her period.

What is the Lunelle combined injectable?
Combined injectables are an injection of estrogen and progestin that you get once a month. Lunelle, manufactured by Pharmacia Inc., was approved as a monthly injectable and was made available in the United States as of June 2000. Lunelle should not be confused with the every-three-months injections of Depo-Provera. The progestin in Lunelle works by stopping ovulation so that an egg is not released, by making cervical mucus thicker so that sperm cannot get through, and by changing the lining of the uterus so that implantation of the fertilized egg in the uterine wall does not occur.

What are the advantages?

• Compared to Depo-Provera, Lunelle offers a woman a more regular bleeding pattern and keeps estrogen levels normal.

• A single injection provides one month of contraception. There's nothing to worry about at the time of intercourse.

• Privacy is a major advantage. No one has to know you are using this method, although a woman does need to return to a clinic each month.

• Fertility comes back quickly. You can get pregnant within an average of three months after stopping Lunelle, compared to about 10 months after stopping Depo-Provera.

• There is no known increased risk of breast cancer.

What are the disadvantages?

• You must return to the clinic every 30 days, unless you learn how to inject yourself and your clinician is willing to provide you with six to 12 injections.

• You may not like repeated injections.

• Lunelle is expensive in some clinics.

• It is not ideal if you're breastfeeding.

• Lunelle may cause breast tenderness.

• This shot causes some weight gain, but less than with Depo-Provera.

• This shot causes some menstrual irregularity, but less than with Depo-Provera.

Where can I go to get started on Lunelle injections?
You can get Lunelle injections from your clinician, health department or family planning clinic. Most clinics provide the first shot when a woman has her period or within seven days after the start of her period.

What if I have sex and I'm late for my shot?
Be sure to use condoms or another birth control method.

What if I have sex and don't use birth control?
Did you know that for 72 hours after sex, you can take emergency contraceptive pills to avoid becoming pregnant? Did you know that for five to seven days after sex, you can have an IUD inserted so you won't become pregnant? Not all clinicians know about these options.

If you want more information or would like the phone numbers of clinicians near you who prescribe emergency birth control, call the toll-free number 888.NOT2.LATE or 800.584.9911. Some of these sources of help are free.

The North Dakota Department of Health, Division of Family Health, does not assume responsibility for the content obtained from external hyperlinks accessed from this website. Any links to external sources are outside of our domain. Information on external websites does not necessarily reflect the views and opinions of the North Dakota Department of Health or the Division of Family Health.