Top 5 Reasons to Avoid Depo-Provera

Depo-Provera is the name for the drug medroxyprogesterone acetate, an injectable contraceptive for women. It is a type of hormonal birth control that works by releasing a synthetic form of progesterone, a hormone naturally produced by the ovaries. The injection is administered once every three months (or 12 weeks) by a GP or community healthcare team.

The mechanism through which Depo-Provera prevents pregnancy includes:

  • Preventing ovulation: It stops the ovaries from releasing eggs. No/fewer eggs mean no chance of fertilisation.
  • Thickening cervical mucus: This makes it harder for sperm to enter the uterus and reach any eggs that might have been released.
  • Thinning the lining of the uterus: If an egg were to become fertilised then it would be harder to be implanted and grow.
  • Depo-Provera is highly effective as a method of birth control when used correctly, with a success rate of over 99% in preventing pregnancy. However, like all contraceptives, it has potential side effects.

I am a male healthcare provider located in Croydon. The reason for writing this article is because I had two patients consult me, one in a GP surgery in Croydon, and one in an NHS outreach clinic in Lewisham. The first patient had been using Depo-Provera for several years, and had recently had a DEXA bone density scan and was osteoporotic. The second patient saw me for advice and support on weight loss. Both patients had found that there were side-effects of Depo-Provera that they were not advised about. I felt very sorry for both patients, and I felt it was my duty to help them, educate them about the risks, and to motivate them to improve their life.

The first question to ask yourself is, why are you being the one who taking a drug for birth control? Would your partner consider injecting a drug into him for the same reason?

I cannot stress enough, that in my opinion, the male should take the lead on birth control during sexual intercourse. It is our seed that males are producing, and we have to take responsibility for that. I take the lead on it in my relationship and all other previous relationships, and I take responsibility for it. I would not encourage or suggest to my wife to take a drug for something that I can prevent through barrier contraception. Ladies, please share this article with your men. Gents, please read about the risks and side-effects below and make the right choice.

The problems with Depo-Provera:

1. Osteoporosis

There is a risk of osteoporosis in patients who have repeated injections of Depo-Provera. Long term use has been clearly associated with a decrease in bone mineral density. In an article in the Lancet in 1994, it was shown that women using Depo-Provera had significantly lower bone density in the lower back and hip. In another study reported in 2022 in the Infectious Diseases in Clinical Practice Journal, the research showed that Depo-Provera use caused significant loss in bone mineral density which may not completely recover after stopping the drug. Do you want to put your body at risk of osteoporosis? No, we must all build and have as much bone density as possible.

Why does this happen? Depo-Provera supresses oestrogen, a key hormone for maintaining bone density. Most of us will know that post-menopausal women are more likely to get osteoporosis due to a loss of oestrogen. For this reason, you don’t want a drug that will also suppress oestrogen.

2. Weight Gain

Struggling to lose weight and not sure why? Perhaps this is a side-effect from a drug. It may or may not be Depo-Provera, there’s lots of potential reasons. However, let’s look at Depo-Provera. Studies show that around half of people who use Depo-Provera experience weight gain. This might be around 2-5 pounds on the lower end. According to the Journal of Pediatric and Adolescent Gynecology, in 1997, a moderate weight gain and BMI is expected with increases of more than 5kg. Another study in 2001 in the same journal associated Depo-Provera with weight gain due to its steroid-like appetite stimulation effect and altered tryptophan metabolism.

Why does this happen? There are a few theories, but it may be due to having an increased appetitive due to the synthetic progestin injected. It can also lead to increased fat mass rather than muscle mass.

3. Irregular Menstrual Cycles

Many women experience irregular menstruation, hormonal imbalance, spotting, and feeling peculiar. It is normal to have a menstrual cycle. It is not normal to suppress it. Many women will have amenorrhea where the periods stop altogether. This hormonal instability is not good. While occasionally someone may be grateful not to have the inconvenience of having a period, is the inconvenience worth the risks or potential side-effects?

4. Mood Changes

When hormones were all-over the place, this can significantly affect your mood. Gents, do you want your partner to have erratic mood swings? Probably not. Some users of Depo-Provera even report depression.

Why does Depo-Provera cause mood swings? It is due to fluctuating hormones (oestrogen and progesterone). They can also affect neurotransmitters in the brain such as serotonin and dopamine. Also if you suffer weight gain or menstrual imbalances, this may affect mood too.

5. Other Side Effects

Apart from the hassle of actually going to get the injection every three months, there is some evidence to suggest other side-effects. These include abdominal pain, reduced sex drive, fatigue, dizziness, hair changes/loss/thinning, sore breasts, headaches, bloating, acne, nausea, and others. Not everyone experiences all of them, and some people may experience none of them, but they are known side-effects.


Depo-Provera has some unpleasant side-effects. Yes it is very successful to prevent fertilisation, but at what cost to your body and mind?

The long and short of it is this: ladies, share this article with your partners. Gents, please just use condoms. If you want advice, call our clinic and ask for an appointment with the person who wrote this article.

(This article is written by a male physiotherapist and health coach).