What are the most common side effects of the Depo-Provera (medroxyprogesterone acetate) shot?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: June 15, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

The most common side effects of the Depo-Provera (medroxyprogesterone acetate) shot include irregular menstrual bleeding or spotting, weight gain, headaches, mood changes, and decreased sex drive, as well as bone mineral density loss with long-term use, as reported in the 2016 study 1. The side effects of Depo-Provera can be categorized into several key areas, including:

  • Menstrual irregularities: irregular menstrual bleeding or spotting, which typically improves after the first year of use, as noted in the 2014 study 1
  • Weight changes: weight gain is another frequent side effect, with users gaining an average of weight, although the exact amount is not specified in the provided studies
  • Hormonal effects: many women experience headaches, mood changes including depression, and decreased sex drive due to the synthetic progesterone in Depo-Provera, as mentioned in the 2014 study 1
  • Injection site reactions: pain, irritation, or bruising can occur at the site of injection, although this is not explicitly stated in the provided studies
  • Bone health: bone mineral density loss is a concern with long-term use, though this is generally reversible after discontinuation, as reported in the 2016 study 1 Other possible side effects include breast tenderness, abdominal pain, dizziness, fatigue, and acne, although these are not as commonly reported. It is essential for patients to be counseled about these potential side effects before initiating Depo-Provera, as well as the importance of maintaining skeletal health through calcium and vitamin D supplementation and regular weight-bearing exercise, as recommended in the 2016 study 1.

From the FDA Drug Label

The most common side effects of medroxyprogesterone acetate injectable suspension include: irregular vaginal bleeding, such as lighter or heavier menstrual bleeding, or continued spotting weight gain abdominal pain headache weakness tiredness nervousness dizziness

The most common side effects of the Depo-Provera (medroxyprogesterone acetate) shot are irregular vaginal bleeding, weight gain, abdominal pain, headache, weakness, tiredness, nervousness, and dizziness.

  • Key points to consider:
    • Weight gain: About two-thirds of women who used medroxyprogesterone acetate injectable suspension in clinical trials reported a weight gain of about 5 pounds during the first year of use.
    • Irregular vaginal bleeding: Women who use medroxyprogesterone acetate injectable suspension may experience irregular or unpredictable bleeding or spotting, which usually decreases over time.
    • Importance of follow-up: It is essential to follow the directions for taking medroxyprogesterone acetate injectable suspension and return every 3 months for the next injection to maintain protection against pregnancy. 2

From the Research

Common Side Effects of Depo-Provera

The most common side effects of the Depo-Provera shot include:

  • Menstrual irregularities, such as irregular or excessive menstrual bleeding 3, 4, 5
  • Weight gain 3, 4, 5, 6
  • Hair loss 5, 7
  • Depression 7
  • Amenorrhea (absence of menstruation) 3

Management of Side Effects

Studies suggest that side effects can be managed through various strategies, including:

  • Short courses of estrogen to improve menstrual disturbances 4
  • Shorter injection intervals to reduce menstrual irregularities 4
  • Aggressive management of side effects to improve long-term use 5
  • Assistance with appointment follow-up to improve continuation rates 5
  • Treatment strategies for episodic vaginal bleeding, hair loss, depression, and weight gain 7

Factors Affecting Side Effects

Research indicates that certain factors can affect the experience of side effects, such as:

  • Prior use of oral contraceptive pills (OCP), which can reduce bleeding duration 6
  • Early administration of the second injection, which can predispose to greater weight gain 6
  • Individual variability in response to the medication 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Long-term contraception with Depo-Provera: a clinical evaluation.

International journal of fertility, 1980

Research

Depo Provera. Position paper on clinical use, effectiveness and side effects.

The British journal of family planning, 1999

Research

Long-term depot medroxyprogesterone acetate (Depo-Provera) use in inner-city adolescents.

The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 1998

Research

Depo-Provera in adolescents: effects of early second injection or prior oral contraception.

The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 1995

Related Questions

How do I switch from oral contraception to Depo-Provera (medroxyprogesterone acetate)?
What are the management options for a 17-year-old patient experiencing depo (medroxyprogesterone acetate) bleeding side effects from Depo-Provera (medroxyprogesterone acetate)?
At what age can Depo-Provera (medroxyprogesterone) be started?
Do you experience menstrual periods while using Depo-Provera (medroxyprogesterone acetate)?
What are the considerations for prescribing Depo-Provera (medroxyprogesterone acetate) to a patient?
What medication is most likely to cause hypoglycemia when combined with metformin, such as glyburide (a sulfonylurea), linagliptin (a dipeptidyl peptidase-4 (DPP-4) inhibitor), Victoza (liraglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist), or semaglutide (a GLP-1 receptor agonist)?
What is the next best step in managing a 30-year-old woman with celiac disease and a history of appendectomy (surgical removal of the appendix) presenting with constipation, alternating constipation and diarrhea, and abdominal pain?
What is the best management approach for a 45-year-old male with a 10-year history of type 2 diabetes (T2D), hypertension, and a 10-year atherosclerotic cardiovascular disease (ASCVD) risk of 10.5%, currently taking aspirin, metformin (metformin hydrochloride), and Januvia (sitagliptin), with an elevated LDL (low-density lipoprotein) and normal HDL (high-density lipoprotein)?
What is the recommended dosage of topical clindamycin (antibiotic) for acne treatment?
Are sewage workers at risk of contracting hepatitis A and leptospirosis?
What is the target blood pressure for a patient with type 2 diabetes and hypertension with a 10-year atherosclerotic cardiovascular disease risk of 10.5% according to ADA guidelines?

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.