What are the considerations for transitioning from oral contraceptives (OCs) to Depo-Provera (medroxyprogesterone acetate)?

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Last updated: April 28, 2025View editorial policy

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From the Guidelines

To transition from birth control to Depo-Provera, you should get your first Depo-Provera injection immediately if it is reasonably certain that you are not pregnant, with no need for a waiting period between methods, and use a backup method like condoms for 7 days to ensure continuous protection 1. When switching from another contraceptive method, the first DMPA injection can be given immediately if it is reasonably certain that the woman is not pregnant, and waiting for her next menstrual period is unnecessary 1.

Key Considerations

  • The first DMPA injection can be given immediately if it is reasonably certain that the woman is not pregnant 1.
  • If it has been >7 days since menstrual bleeding started, the woman needs to abstain from sexual intercourse or use additional contraceptive protection for the next 7 days 1.
  • For the injection, you'll receive 150mg of Depo-Provera intramuscularly every 12-13 weeks (3 months) 1.

Potential Side Effects

  • Depo-Provera may cause irregular bleeding initially, and return to fertility after stopping may take 9-10 months on average 1.
  • Other potential side effects include weight gain, headaches, and mood changes 1.

Importance of Follow-up Appointments

  • Regular follow-up appointments are important to maintain contraceptive effectiveness 1.
  • Patients should be counseled about measures that promote skeletal health, such as daily intake of 1300 mg of calcium and 600 IU of vitamin D and regular weight-bearing exercise 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Transitioning from Birth Control to Depo

  • The study 2 focused on the use of longer-acting contraception methods, including depot medroxyprogesterone, among transmasculine and cisgender patients.
  • The research found that the uptake of these contraception methods increased from 2009 to 2019 for both groups, with a positive linear trend for both groups (p = 0.003 and p < 0.001, respectively).
  • However, the study does not specifically address the transition from birth control to Depo, but it does provide information on the increase in uptake of depot medroxyprogesterone among the studied population.
  • The transmasculine group showed a greater increase in the uptake of intrauterine devices and etonogestrel implants compared to the cisgender group.
  • The study suggests that there is an improvement in the use of long-term contraception and menstrual suppression medications for the transmasculine population, but further research is needed to understand the differences and identify possible unmet needs.

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.

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