What You Need To Know About The Birth Control Shot

We at Bustle love giving you tips for how to tap into your sexual potential and troubleshoot when things aren’t going your way in the bedroom. But what about finding solutions to those stressful sexual health situations that inevitably crop up when you’re getting down? Emma Kaywin, a Brooklyn-based sexual health writer and activist, is here to calm your nerves and answer your questions. This week’s topic: how the Depo-Provera birth control shot works.

Q: I’ll just come right out and say it — I’m not great at taking my birth control pill. I love the way the hormones make my skin nice and my boobs bigger, but I forget enough doses that I’ve had to take Plan B a couple of times and just get generally stressed over messing up and ending up pregnant. I’ve looked into some of the options that are longer-lasting than 24 hours, and I gotta say I don’t really want anything up me (other than someone else!), so the ring and IUD are out for now. I’m interested in the shot, but I don’t know much about it. Do I do the birth control shot myself? I’ve never given myself a shot before, that seems hard. Is it safe? Basically, is this an option I should consider?

A: When the birth control pill came out in the 1960s, it revolutionized family planning, allowing humans with uteruses to decide when they wanted to have kids. To which we say hooray! But let’s be real for a moment: it’s really hard to take a pill every day. In fact, this is one of the biggest challenges in healthcare. Lucky for us, there are an increasing number of options on the market that are just as good at blocking pregnancy as the original oral hormonal birth control pill, but that take out the daily human component called memory. One of these is Depo-Provera, the commercial name for the birth control shot. Here's what you need to know.

What Is Depo-Provera?

Depo-Provera, often called “Depo” for short, is a shot of hormones you can get that will protect you from pregnancy for three months at a time. That’s right, three whole months that you don’t have to worry about creating a tiny human.

How does this magic happen? The shot contains progestin, which is the synthetic version of progesterone, a hormone central to controlling your menstrual cycle. Progestin works to stop your ovaries from releasing eggs (called ovulation), and also hinders sperm from being able to meet up with your egg by thickening your cervical mucus so that those little dudes are literally blocked.

How Effective Is It?

The great news is that the birth control shot is super effective. If used perfectly, it has over 99 percent effectiveness, which means that if you follow instructions, less than one human in 100 will get pregnant. If, however, you forget to show up for your shot every three months, that rate can go down to around 94 percent.

One thing to remember though: Like the pill, Depo is NOT a barrier method of contraception, which means it doesn’t protect you from catching sexually transmitted infections. So if you’re on the shot but still want to protect yourself from things like HIV, chlamydia, gonorrhea, and syphilis, throw a condom into the mix.

What’s It Like To Get It?

If you want to start using Depo, you have to talk to your gynecologist so she can give you a prescription for it. She’ll probably also run some tests — like checking your blood pressure and making sure you’re not already pregnant.

The actual procedure is a shot deep into your muscle, usually into either your arm or butt (because those two body parts are totally the same … said no one ever). This can make you feel sore for a bit afterwards, but it generally goes away pretty fast. Depending on when in your cycle you get your first shot, you may have to use an alternate form of birth control for up to a week to account for your natural fertility while the progestin gets to work. After the first shot though, you can just get subsequent shots back to back without using backup methods.

Can I Give It To Myself?

If you’re the DIY sort of type, or you live in a place where reproductive healthcare is hard to access (cough, Texas, cough), you can give yourself the shot. You have to be trained to do it, and the type of Depo you'll get is a bit different — you don’t have to go all the way to the muscle on your own, DIY Depo is subcutaneous, which means it's administered just under the skin. The syringes are pre-filled so all you have to do is point and shoot. If you’re interested in this option, talk to your healthcare provider so she can order this version of it and teach you how to use it.

What Are The Possible Side Effects?

Luckily, extremely negative reactions to the birth control shot are rare; and since the Depo shot contains only progestin, it's a good option for those who might be sensitive to high doses of estrogen. That said, some people feel not great on the shot. While this is true of all hormonal birth control (because hormones are powerful stuff) it can be a bit more intense on the shot because you get a three-month supply all at once and you can’t get it out of your body if you start feeling icky.

The most common side effect is spotting between periods, although this usually gets better over two or three cycles. Other negative side effects can include abdominal pain, sore breasts, acne, lowered libido, depression, headaches, dizziness, nervousness, weight gain, and fatigue. There’s also some research that Depo can cause bone mineral density loss over time, particularly if you’ve been using it for more than two years.

Now, onto the good stuff: Depo minimizes periods, and some people don’t bleed at all when on the shot. It also can help menstrual cramp pain. Finally, it decreases your risk for developing endometrial cancer. It’s up to you to weigh these benefits and potential challenges.

How Much Will It Cost Me?

A fancy shot seems like it’s gonna cost a lot, right? Actually it’s not that bad — out of pocket, Depo costs around $25 per month, which is about as much as the birth control pill. And if you have health insurance, it should be free. Thanks Obamacare!

The Bottom Line

Depo-Provera is a really good option in the world of hormonal birth control. If you don’t get intense side effects from hormones, you’re a particularly good candidate to get a three-month supply all at once and then just forget about it until your next shot. Because the whole point is to have a good time, and not be thinking about trying not to make babies.

Images: Getty, Giphy