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If you’ve clicked on this article, chances are, you’re someone who needs effective birth control. It’s also likely that you’re not a fan of taking a pill every day. Oh, and you still want to get pregnant someday, right?
Well, you’ve come to the right place, because we’re about to answer all of your pressing questions about Depo-Provera, or, as it’s more commonly known, the Depo shot. Depo-Provera is an injectable birth control that doesn’t require a daily pill intake. But probably the biggest question on your mind is if the Depo shot — being a long-term form of contraception — can cause infertility.
Let’s settle those fears right away: Caledonia Buckheit, M.D., a board-certified OB/GYN practicing in Raleigh, North Carolina, confirms to Rescripted that no, the Depo shot does not cause infertility. But — because there's always a but — there can be situations where your fertility may not return right away after stopping Depo injections.
Read on for Dr. Buckheit’s advice on the pros and cons of the Depo shot.
What is Depo-Provera?
Depo-Provera, also known as medroxyprogesterone acetate, is a “long-acting, progesterone-only injection birth control,” explains Dr. Buckheit. It prevents pregnancy by “blocking ovulation, thickening the cervical mucus, and thinning the endometrial lining.”
Even though the Depo shot is a long-term form of birth control — you would receive injections every three months — it isn’t permanent. If you choose to stop the injections, “your body’s natural hormonal environment and ovulation will return over time, and the contraceptive effect will go away,” assures Dr. Buckheit.
Pros of Depo-Provera
In addition to “[Depo-Provera] being highly effective at preventing pregnancy,” Dr. Buckheit highlights several benefits to this form of contraception: Instead of remembering to take a pill every day, you would get an injection every three months. You may also experience either lighter or absent periods.
Some people may opt for a contraceptive injection because they can’t or don’t want to use estrogen. Or, they have health problems like anemia, seizures, sickle-cell disease, endometriosis, or uterine fibroids.
Other pros of taking Depo-Provera include:
- Fewer menstrual cramps and less overall pain
- A lowered risk of uterine and endometrial cancer
Cons of Depo-Provera
Depo-Provera may not be the right contraceptive choice for you if you have certain underlying conditions. Before starting the Depo shot, speak to your healthcare provider if you've experienced any of the following:
- Unexplained vaginal bleeding
- Breast cancer
- Liver disease
- A history of heart attack or stroke
- Diabetes
- Uncontrolled high blood pressure
Other potential risk factors
As with anything concerning your body, the decision to try Depo-Provera should not be taken lightly. It’s important to weigh both the benefits of the Depo shot and its risk factors equally: “Weight gain and loss of bone density are two side effects I always mention to patients considering starting this method,” warns Dr. Buckheit. If you have additional risk factors for osteoporosis (family history, some eating disorders, etc.), speak to your healthcare provider about whether or not the Depo shot is the right option for you.
Dr. Buckheit also mentions that “depending on personal risk factors, the slightly increased risk of developing breast cancer or blood clots may also be a relevant concern for those considering this method.”
The Depo shot, fertility, and you
For the record, “the Depo shot causes temporary suppression of ovulation (this is why it is an effective birth control method!), but does not cause long-term infertility,” says Dr. Buckheit.
But, everyone’s body is different. While “Depo is approved to prevent pregnancy for three months after each injection,” Dr. Buckheit does caution that “fertility may not return right at the three-month mark.” So if you’ve been doing the Depo shot, and you stop because you want to get pregnant, it’s a good idea to mentally prepare for the possibility that you might be trying to conceive a little bit longer than initially planned. “For some, ovulation will return 12-14 weeks from the final injection,” says Dr. Buckheit. “For others, it could be up to 10 months before natural fertility returns.”
That doesn’t mean, however, that you should TTC without seeking medical advice at some point, either. “I would recommend checking in with your OB/GYN if menses have not returned by six months post-injection, or if you have not had success getting pregnant within a year after your last Depo shot,” says Dr. Buckheit. “People who are older than 35, or who have certain health conditions (like PCOS or endometriosis), should seek care earlier on.”
The good news is that using Depo-Provera as your birth control will not put your fertility at risk. Now, if you’re on a strict TTC timetable, and can’t wait several months after stopping Depo shots, then contraception injections may not be the right choice for you. But otherwise, after you’ve consulted with your healthcare provider, you can embrace the freedom that the Depo shot provides.
So long, daily pills!
Sarene Leeds holds an M.S. in Professional Writing from NYU, and is a seasoned journalist, having written and reported on subjects ranging from TV and pop culture to health, wellness, and parenting over the course of her career. Her work has appeared in Rolling Stone, The Wall Street Journal, Vulture, SheKnows, and numerous other outlets. A staunch mental health advocate, Sarene also hosts the podcast “Emotional Abuse Is Real.” Subscribe to her Substack, the Critical Communicator, and follow her on Instagram, BlueSky, or Threads.