In every pregnancy, a woman starts out with a 3-5% chance of having a baby with a birth defect. This is called her background risk. This sheet talks about whether exposure depot medroxyprogesterone may increase the risk for birth defects over that background risk. This information should not take the place of medical care and advice from your health care provider.

What is depot medroxyprogesterone acetate?

Depot medroxyprogesterone acetate is a lab-made hormone. This medication is similar to the female hormone progesterone. There is a MotherToBaby fact sheet on progesterone, available at https://mothertobaby.org/fact-sheets/progesterone/pdf/. Depot medroxyprogesterone is sold under the brand name Depo Provera®.

The depot medroxyprogesterone acetate shot is used to prevent pregnancy (as birth control). The shot works for approximately 90 days but the medication may be found in the bloodstream longer. It is recommended that women receive a shot every 90 days to prevent pregnancy. Depot medroxyprogesterone acetate is not the same as oral birth control pills, which contain other hormones.

Depot medroxyprogesterone acetate can also be used to treat menstrual disorders and, at high doses, can be used to treat certain types of cancer. This fact sheet is written specifically for the contraceptive depot medroxyprogesterone acetate shot.

I am using the depot medroxyprogesterone acetate shot as birth control. I would like to try to get pregnant. How long does the drug stay in my body?

Everyone is different. However, on average, it takes around 120 to 200 days after your last shot for the medication to be out of your body. The manufacturer of Depo Provera® found that most women who try to get pregnant after using depot medroxyprogesterone acetate get pregnant within 18 months after their last shot.

Women who are trying to get pregnant should talk to their healthcare providers about taking folic acid before trying to get pregnant.

What are the effects on my baby if I was already pregnant when I received my depot medroxyprogesterone acetate shot?

The majority of studies have not found a higher chance of birth defects with depot medroxyprogesterone acetate exposure during the first trimester. Limited studies have not shown long term health problems from use of depot medroxyprogesterone acetate during pregnancy.

Also, studies have not found that depot medroxyprogesterone acetate causes an increased chance for ectopic pregnancy (when a fertilized egg implants somewhere other than the uterus), or pregnancy loss. When you know you are pregnant you should not continue getting the depot medroxyprogesterone acetate shots.

Are there any effects if I use depot medroxyprogesterone acetate while breastfeeding?

In women using depot medroxyprogesterone acetate during breastfeeding, the amount of hormone found in the breast milk is very small. Many studies have shown that the hormone in breast milk appears to have no effect on the baby’s long term growth and development. If a woman is going to use depot medroxyprogesterone acetate, the World Health Organization and the product label recommend waiting 6 weeks after the baby’s birth before starting. Be sure to talk to your healthcare provider about all of your breastfeeding questions.

Selected References:

  • Baheiraei A, et al. 2001. Effects of progestogen-only contraceptives on breast-feeding and infant growth Int J Gynaecol Obstet, 74; 203–205
  • Borgatta L, et al. 2002. Pregnancies diagnosed during Depo- Provera use. Contraception. Sep;66(3):169-72.
  • Dahlberg K. 1982. Some effects of depotmedroxyprogesterone acetate (DMPA): Observations in the nursing infant and in the long-term user. Int J Gynaecol Obstet 20:43-48.
  • Gray RH and Pardthaisong T. 1991. In utero exposure to steroid contraceptives and outcome of pregnancy. Am J Epidemiol 134:795-803.
  • Hogue CJ. 1991. Invited commentary: the contraceptive technology tightrope. Am J Epidemiol 134: 812-815; author response 816-817.
  • Jaffe B et al. 1990. Health, growth and sexual development of teenagers exposed in utero to medroxyprogesterone acetate. Paediatr Perinat Epidemiol 4:184-95.
  • Jimenez J et al. 1984. Long-term follow-up of children breast-fed by mothers receiving depotmedroxyprogesterone acetate. Contraception 30:523-533.
  • Koetsawang S, et al. 1982. Transfer of contraceptive steroids in milk of women using long-acting gestagens. Contraception 25:321- 331.
  • Pardthaisong T, et al. 1992. The long-term growth and development of children exposed to Depo-Provera during pregnancy or lactation. Contraception 45:313-24.
  • Pardthaisong T and Gray RH. 1991. In utero exposure to steroid contraceptives and survival during pregnancy. Am J Epidemiol 134:804-811.
  • PDR Entry for:Depo-Provera Contraceptive Injection. 2016. Pharmacia and Upjohn Company LLC.
  • Phillips SJ, et al. 2016. Progestogen-only contraceptive use among breastfeeding women: A systematic review. Contraception; 94:226-52.
  • Ratchanon S and Taneepanichskul S. 2000. Depot medroxyprogesterone acetate and basal serum prolactin levels in lactating women. Obstetrics & Gynecology 96(6):926-8.
  • Saxena BN et al. 1977. Levels of contraceptive steroids in breast milk and plasma of lactating women. Contraception 16:605-613.
  • Virutamasen P et al. 1996. Pharmacodynamic effects of depot-lprogesterone acetate (DMPA) administered to lactating women on their male infants. Contraception 54:153-157.
  • World Health Organization Department of Reproductive Health and Research. 2015. Medical eligibilty criteria for contraceptive use: Executive summary. Fifth ed. Geneva. http://apps.who.int/iris/bitstream/10665/172915/1/WHO_RHR_15.07_eng.pdf?ua=1 .
  • Yovich JL, et al. 1988. Medroxyprogesterone acetate therapy in early pregnancy has no apparent fetal effects. Teratology 38:135-144.