.png)
If you're considering the birth control shot or already using it, you probably have questions about keeping up with your schedule, managing refills, and knowing what to expect. The Depo-Provera shot is a highly effective form of birth control that prevents pregnancy for three months at a time — but staying on track with your injections is essential for continuous protection.
Let's walk through everything you need to know about the birth control shot, from how it works to managing your refill schedule and what side effects you might experience along the way.
The birth control shot (also called Depo-Provera or Depo-Provera CI) is an injectable contraceptive that contains the hormone progestin. It's one of the most effective hormonal birth control methods available, with a success rate of over 99% with perfect use and 96% with typical use.
Depo-Provera contains depot medroxyprogesterone acetate, a synthetic version of the hormone progestin. This hormone works in three ways to prevent pregnancy:
First, it stops ovulation, which means your ovaries don't release an egg each month. No egg means sperm has nothing to fertilize. Second, the shot thickens your cervical mucus, creating a barrier that makes it harder for sperm to reach an egg if one were released. Third, it thins the uterine lining, which would make it difficult for a fertilized egg to implant.
You'll receive your first shot during the first five days of your menstrual cycle, which provides immediate protection against pregnancy. After that initial injection, you'll need to return for your next shot every 11 to 13 weeks (roughly every three months).
There's also Depo-SubQ Provera 104, a lower-dose version that you can learn to self-administer at home. It contains 104 mg of medroxyprogesterone acetate compared to the standard 150 mg dose. Both versions work the same way and require the same dosing schedule. Twentyeight Health offers the 104mg SQ dose that is received in the mail and done at home. The 150mg IM dose is for in-office supply only.
Benefits of the birth control shot:
Privacy and discretion are major advantages. Nobody needs to know you're using birth control. You don't have to remember a daily pill or deal with visible methods like the patch. The shot can reduce heavy periods and menstrual cramps for many people, and some users stop getting their period entirely after a few doses. It's safe to use while breastfeeding and doesn't contain estrogen, making it a good treatment option for people who can't use combined hormonal contraceptives.
Considerations to keep in mind:
Schedule discipline is non-negotiable. You must return every three months for your injection, which requires planning ahead. Unlike birth control pills you can simply stop taking, the shot's effects last for months. So, you can't reverse it once you receive the injection. Weight gain is a common side effect that affects many users. According to research, people using Depo-Provera gain an average of 5 pounds in the first year.
The shot doesn't protect against sexually transmitted infections, so you'll need to use condoms if STI prevention is a concern. Some people also experience irregular bleeding, mood changes, or decreased bone density with long-term use.
Timing matters with the birth control shot. Missing your scheduled injection or getting it late can put you at risk for unplanned pregnancy. Here’s a helpful guide to help you navigate when it’s time for your next injection!
Your healthcare provider will typically schedule your next appointment before you leave their office. Mark this date in your calendar immediately and set multiple reminders — one month before, two weeks before, and one week before your appointment.
While the shot is designed to last three months, you have a two-week grace window. If you're scheduled for your injection at 12 weeks but can't make it until week 13 or the beginning of week 14, you're generally still protected. However, medical conditions and individual factors can affect this timeline, so always check with your healthcare provider about your specific situation.
If you're more than two weeks late for your shot, you'll need to take a pregnancy test and use backup birth control methods (like condoms) until you receive your next injection and for the first week afterward.
At Twentyeight Health, our providers can help you stay on track with convenient telehealth appointments and prescription management. We'll send you reminders before your next dose is due so you never miss your window.
Planning a trip during your injection window? Contact your healthcare provider in advance to discuss your options. You might be able to get your shot slightly early (usually up to two weeks before your scheduled date) or arrange for an injection at your destination.
If there's any chance you'll be late for your next shot, stock up on backup contraception before you leave. Condoms are essential not just for pregnancy prevention but also for protecting against sexually transmitted infections.
Like all hormonal contraceptives, the birth control shot can cause side effects. Understanding what's normal and what warrants a call to your healthcare provider helps you stay informed about your health.
Irregular periods are the most common side effect of Depo-Provera. During the first few months, you might experience unpredictable spotting or bleeding. Some people have longer or heavier periods initially, while others notice lighter bleeding or shorter periods.
After several injections (usually three to four shots), many users stop getting their period entirely. According to the FDA, about 50% of people using Depo-Provera have no periods after one year, and that number increases to 68% after two years. This is completely normal. Your body is simply responding to the hormone.
If you experience very heavy bleeding that soaks through a pad or tampon every hour for several hours, or if bleeding lasts more than seven days, contact your healthcare provider.
Weight gain is a significant concern for many people considering the birth control shot. Research shows that Depo-Provera users gain an average of 5.4 pounds during the first year, and weight gain may continue with prolonged use. Not everyone experiences this side effect, but it's common enough that you should be aware of the possibility.
Some people report increased appetite after starting the shot. Paying attention to hunger cues, maintaining regular physical activity, and eating balanced meals can help manage potential weight changes.
Other common side effects can include mood swings, headaches, breast tenderness, or decreased sex drive. Some people experience bone density loss with long-term use (more than two years), which is why it’s recommended discussing this risk with your healthcare provider, especially if you have other risk factors for osteoporosis.
More serious but rare adverse effects include allergic reactions, signs of blood clots (leg pain, chest pain, shortness of breath), severe headaches, yellowing of the skin or eyes (potential liver disease), or symptoms of a heart attack or stroke. Seek immediate medical attention if you experience any of these symptoms.
Contact Twentyeight Health providers if you experience heavy or prolonged bleeding that concerns you, severe headaches or vision changes, signs of depression or significant mood changes, severe abdominal pain, or any symptoms that significantly affect your quality of life.
Life changes, and so might your contraceptive needs. Whether you're thinking about switching from the Depo-Provera shot to another method or planning future pregnancies, understanding the transition process is important.
When you stop getting the birth control shot, your body doesn't return to normal immediately. The synthetic hormone can remain in your system for several months after your last injection.
Fertility typically returns within 10 months after your last shot, though it can take up to 18 months for some people. If you're planning to get pregnant soon, the Depo shot might not be the best choice. Your menstrual cycle will gradually return during this time, though it may be irregular at first.
If you want to switch to another contraceptive method like the pill, patch, or ring, timing matters for continuous pregnancy prevention. Start your new method before your next shot would be due, or use backup contraception during the transition.
When switching to birth control pills, start the first day of your new pack on the day your next injection would have been scheduled. The same applies to the patch or ring—begin using it when your next shot is due.
Consult with your healthcare provider about the best timing for your specific situation. At Twentyeight Health, our providers can help you transition smoothly between different birth control methods through convenient telehealth consultations.
Managing your birth control shot refills doesn't have to be complicated. With online healthcare services, getting your prescription renewed and coordinating your injections is simpler than ever.
At Twentyeight Health, we make staying on schedule easy. Our providers can prescribe Depo-Provera and help you coordinate where to receive your injection—whether at our partner clinics, your local pharmacy, or through home administration if you're using Depo-SubQ Provera 104.
We'll track your injection schedule and send you reminders before your next dose is due. If you're eligible for self-administration, we can ship your prescription directly to your door in discreet packaging with free shipping.
Managing your birth control refills and renewals is straightforward through our platform. Simply message your provider when you need a refill, and we'll handle the prescription renewal process.
If you're up to two weeks late, contact your healthcare provider immediately. You may still be protected, but this depends on individual factors. If you're more than two weeks late, take a pregnancy test and use backup birth control like condoms until you receive your next injection and for seven days afterward.
Yes. If your shot is more than two weeks late, use condoms or another backup method during sexual intercourse until you receive your next injection. Continue using backup contraception for the first seven days after receiving the late shot to ensure full protection.
If you receive your first shot during the first five days of your menstrual cycle, protection starts immediately. If you get it at any other time, use backup birth control for the first week after the injection.
Want to learn more about whether the birth control shot is right for you? Connect with a Twentyeight Health provider today for personalized guidance about all your birth control options. We're here to support your reproductive health journey with judgment-free care and convenient telehealth services.
This article was reviewed by Twentyeight Health's clinical team. The information provided in this article is for educational purposes only and does not constitute medical advice, diagnosis, or treatment. This content does not establish a provider-patient relationship. Always consult a licensed healthcare professional regarding any medical concerns.
.png)
%20(6).png)