Birth control shot (Depo-Provera): Frequency Asked Questions

For most people, the risk of blood clots when using the ring, the patch, or the combined birth control pill (which is the most common type of pill) is low. But smoking increases this risk. If you are over 35 and smoke 15 or more cigarettes a day, the combination pill, patch, and ring are not safe options for you. If you’re over 35 and you smoke less than 15 cigarettes a day, talk to your provider about whether these birth control methods are safe options for you. People who smoke can always use the IUD, the implant, the shot, the mini-pill (progestin-only pill), and any method that is hormone free (like condoms, for example).

One of the main ways hormonal birth control prevents pregnancy is by stopping ovulation—so the egg never leaves the carton, so to speak. The pill, the patch, the ring, and the shot are most reliable at blocking ovulation, so people using these methods may have fewer ovarian cysts. If you tend to get ovarian cysts, your provider may recommend one of these methods to prevent future cysts. /The progestin-only or mini-pill has an unpredictable effect on ovulation and may lead to more cysts. These almost always disappear on their own, but if you’ve had problems with cysts in the past, the mini-pill may not be the best contraception for you.

If you’re already on Depo and you’ve decided you want to get pregnant, you’re going to have to wait it out. There’s no way around it. But 12 weeks after your last injection, you’ll be ready to start trying. It may take some time, though. Sometimes it can take up to 10 months after the last shot for fertility to come back completely.

For women with high blood pressure, methods with estrogen–the pill (except for the mini-pill), the ring, and the patch–may make their blood pressure even higher, increasing the risk of a heart attack or stroke. Fortunately there are lots of highly effective birth control options that are safe and estrogen-free like the IUD, the implant, or the shot. Talk to your doctor about your condition and what birth control is best for you.

Using a method of birth control with estrogen, like the pill, patch, or ring, increases the risk of forming a blood clot, but the risk is so low that if you don't have any factors that increase your chances of having a blood clot, you can safely use all types of birth control. If you do have an increased risk of blood clots because you've had one before you've had a stroke or heart attack, or you have a medical condition that increases your risk of a blood clot, like high blood pressure, then adding birth control with estrogen to the mix increases your risk too much and it's not recommended that you use birth control with estrogen in it. But that doesn't mean there isn't a birth control method for you!

If you can't take estrogen, you have quite a few options available to you. First you have the non-hormonal methods, like the copper IUD. You can also use any of the hormonal methods that only contain progestin, not estrogen, like the implant, mini-pill, shot, and hormonal IUDs, like Mirena, Skyla, Liletta, and Kyleena. These don't increase your risk of blood clots and are all really good at preventing pregnancy.

If you're worried about blood clots or don’t know if you have risk factors, talk to a health care provider about which birth control methods are options for you.

As long as you get your shots on time, this method is very effective. With perfect use the shot is more than 99% effective; with typical use, the it’s closer to 94%.

In other words:

Of those women who use the shot exactly as directed, fewer than 1 in 100 will experience an accidental pregnancy during the first year of using this method.

Of those women who do not use the shot exactly as directed, fewer than 6 in 100 will experience an accidental pregnancy during the first year of using this method.

If you feel like your birth control is changing your behavior, it's time to talk to your health care provider. Everybody responds to birth control differently, and your provider can help you decide whether it's time to try something else. It might be a matter of switching hormonal methods or deciding whether to avoid hormonal birth control altogether, or you may choose to wait it out since some negative side effects go away with time. The bottom line: If your current method is making you feel blah, don't settle. There are a lot of methods to choose from and sometimes it can take a few tries to get it right.

Yes. Ibuprofen and other NSAIDs, like naproxen, can decrease menstrual flow and cramping. So if you have heavy or painful periods, your health care provider may recommend taking ibuprofen to help reduce heavy flow and/or cramping. It can also help reduce the irregular bleeding that is sometimes a side effect of progestin-only birth control methods like the shot or the implant.

First, figure out if there’s other stuff going on in your life that could be causing you to lose your sex drive. Like, are you stressed? Or having relationship issues? You might want to try exercising more, therapy, or changing things up in the bedroom.

Is there anything else going on your life that could be causing you to feel moody? Look into that first.