Birth Control: Subcutaneous Shot (Depo SubQ Provera®)

The birth control shot (Depo-SubQ Provera^®) is given once every 13 weeks. The shot contains a small amount of progesterone, similar to the hormones that are naturally made in a woman’s body. The shot prevents pregnancy by stopping the egg from being released from the ovary. This shot also changes the cervix mucus to keep sperm from reaching an egg.

Advantages of the Shot

• more than 94% effective with typical use
• lasts for 13 weeks at a time
• you can give it yourself at home
• lighter periods
• periods may stop completely
• lighter cramps
• may improve premenstrual syndrome (PMS)
• you can get the shot immediately after giving birth
• safe with breastfeeding

Disadvantages of the Shot

• You can get pregnant if you are late getting your shot or miss a shot.
• Possible side effects are weight gain and changes in your mood.
• Your periods will be irregular. Rarely, women may have more days of bleeding than before they started the shot.
• Some women may have a delay in getting pregnant after stopping the shot.

Risks

Decreased bone density: The shot may cause a drop in bone mineral density. The risk is highest for women less than 20 years of age. There is no proof that this causes broken bones. We recommend that young women using the shot eat three servings of calcium-rich foods daily. This can include milk, yogurt, cheese, almonds and leafy greens.

Who Cannot Get it

The birth control shot should not be used by people who have:

• unexplained vaginal bleeding that they have not discussed with a health care provider
• a history of a stroke
• diabetes with complications
• lupus with antiphospholipid antibodies

Tell your health care provider if you have any of these risk factors or conditions, or any other medical concerns.

Storage

• Store this medicine at room temperature.
• Store items out of the reach of children and others who might misuse them.
• Keep items clean and free of dust.

How to Give the Shot

1. Collect needed supplies including:
   • Depo medicine - Read the label on the bottle. Make sure it is the right medicine and that it is not expired.
   • alcohol pad, bandage (if desired)
   • sharps container (Picture 4)
2. Choose your injection site (Picture 2). Options include:
   1. upper, outer leg (thigh)
   2. lower abdomen (except the area right around the navel and waistline)
3. Wash your hands with soap and water for at least 15 seconds. Rinse and dry.
4. Gently clean the skin where you plan to inject the shot with the alcohol swab.
5. Take the syringe out of the package, gently shake for one minute, then remove the cap.
6. Attach the needle to the syringe, then move the safety shield away from the needle. Remove the plastic needle cover from the needle.
7. Hold the needle pointing up. Gently push the plunger until the liquid reaches the top and all of the air has been pushed out. Do not push out any of the liquid.
8. Pinch the skin around the chosen injection site.
9. Push the small needle all the way into the skin at about a 45-degree angle and inject the Depo slowly, over 5 to 7 seconds (Picture 3).
10. Make sure to push the plunger all the way down and inject the medicine completely under the skin. Remove the needle from the skin.
11. Push the green safety shield over the needle until it clicks. Do this by pressing the safety shield against a hard surface to secure it over the needle. Do not use your other hand because it may cause an accidental finger stick.
12. Do not recap the used needle. Do not bend or break off the needle. Do not remove the needle from the syringe.
13. Put the used syringe with the attached needle into the sharps container (see the next section).
14. Apply pressure to the injection site and cover it with a bandage, if desired.

How to get rid of Sharps at Home

1. If you do not have a hospital-issued sharps container, use a container made of hard, heavy-duty plastic. This can be a laundry detergent bottle or liquid laundry softener bottle (Picture 4). It must close with a tight lid that screws on. Needles should not be able to puncture (poke through) the  lid. The container must be leak-proof, and able to sit up and not fall over.
2. DO NOT use milk containers, water bottles, clear plastic containers, glass containers or soda cans as sharps containers.
3. Put the used syringe with the needle into y our chosen sharps container. Make sure the sharp end, or the pointed end, goes into the container first and is not sticking out of the top of
   the container.
4. Carry a portable sharps container when traveling.
5. If you are using a household container, close the lid and duct tape it shut when the container gets no more than ¾ full (Picture 4). Label the container “SHARPS-DO NOT RECYCLE.” Put it in the middle of a full trash bag. In the state of Ohio, you are allowed to put the trash bag out for regular trash pick-up. If you live in a state that has a sharps disposal program, take the sealed and marked container to the right disposal center. DO NOT put the container in recycling or return to a store to recycle (Picture 5).
6. Talk to the health care provider and pharmacist when your child gets a prescription for any injection (shot). Some medicine companies have programs that let you mail back your sharps container. See here for more information.
7. Keep all syringes, needles and sharps containers out of the reach of children and others who may misuse them.

When to Call the Health Care Provider

Call the doctor or health care provider right away if you:

• think you are pregnant.
• think you might have a sexually transmitted infection (STI).
• are depressed or your mood has changed after starting the shot.

Preventing STIs

The birth control shot does not protect against sexually transmitted infections (STIs). Condoms are the best way for sexually active people to reduce the risk of infection. Always use a condom when you have sex. Get yearly health check-ups, including testing for STIs.

 Birth Control: Subcutaneous Shot: Depo-SubQ Provera (PDF)

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