Birth Control Pill vs. Depo-Provera Shot

Medically Reviewed on 3/3/2023

Is Depo-Provera the most effective birth control?

Is the birth control pill more effective than Depo-Provera?
Is the birth control pill more effective than Depo-Provera?

Both the pill and the shot are very effective methods of birth control.

  • When combination birth control pills are taken correctly, they are up to 99% effective in preventing pregnancy.
  • Progestin-only pills are about 95% effective.
  • The birth control shot (Depo-Provera) also is about 99% effective in preventing pregnancy (the average annual failure rate is about 3%).

What are the differences and similarities between how birth control pills and Depo-Provera work?

Birth control pills and the birth control Depo-Provera shot are both hormonal methods of birth control. This means that they work by changing hormone levels in your body, preventing pregnancy from occurring. The hormones in birth control pills prevent the release of an egg or ovulation.

Birth control pills

Birth control pills are available as combination pills, containing the hormones estrogen and progestin, or as mini-pills containing progestin only.

  • Both typically come in packs of 28 pills, and you take one pill daily.
  • With combination pills, the last 7 pills in the pack do not contain hormones, and while you are taking these non-hormone pills, your menstrual period occurs.
  • The menstrual period also occurs during the last 7 days of the progestin-only pill packs.
  • Some newer types of birth control pills are taken continuously for a few months without the inactive pills before a menstrual period occurs.
  • The pill also works to make the cervix (opening to the womb or uterus) and the uterus itself unfavorable for a pregnancy to begin.

Depo-Provera shot

  • The birth control shot is known as Depo-Provera (and the newer low-dose Depo-SubQ Provera 104).
  • The Depo-Provera shot contains the hormone progestin and prevents pregnancy for three months in a row.
  • Like the hormones in birth control pills, the progestin in the shot makes the environment in the uterus unfavorable to begin a pregnancy and may stop ovulation.


Choosing Your Birth Control Method See Slideshow

Does Depo have the same side effects as the pill?

Unique side effects of oral contraceptives

  • Nausea
  • Vomiting
  • Mood changes
  • So-called “breakthrough” bleeding or spotting at times other than the menstrual period.
  • The side effects of the pill tend to get better after you have been using it for a few months.

Unique side effects of the Depo-Provera injection

Similar side effects of the pill vs. Depo-Provera injection

Do you gain more weight on Depo or on the pill?

Yes, women have reported weight gain while taking oral contraceptives and using the Depo-Provera shot.

Does Depo ruin your fertility?

While the Depo-Provera shot does not ruin fertility, it may cause a slight delay in the return to fertility after discontinuation. The synthetic progestin hormone in the Depo shot can remain in your body for up to 12 weeks following your last injection. This can prevent ovulation and cause a delay in normal menstrual cycles.

Why is Depo not recommended for long term use?

Although the Depo-Provera shot is an effective form of contraception, it is not recommended for long-term use due to the shot's potential impact on bone health. Bone density may decrease over time because of the shot's synthetic progestin hormone ingredient. Your risk of osteoporosis or bone fractures increases the longer you take the shot. However, bone density may return to normal levels over several years after stopping the shot.

What is an advantage of Depo-Provera?

One of the major advantages of the Depo-Provera shot is that it is highly effective at preventing pregnancy. The shot has a failure rate of less than 1% which makes it one of the most effective forms of contraception available on the market.

What are the disadvantages of the Depo shot and birth control pill?

Both the pill and the shot do not offer any protection against sexually transmitted diseases (STDs). Missing pills or taking longer than 12 weeks to get another shot increases the chances of becoming pregnant.

Other health risks of oral contraceptives

  • Combination birth control pills have been linked to a small increase in the risk of a heart attack. However, this is a very rare event in young women.
  • Birth control pills that contain estrogen increase the risk of blood clots, and some types of pills may increase the risk of stroke. Because of these risks, it is recommended that women over age 35 who smoke cigarettes, hookahs, etc. (tobacco) not use birth control pills.
  • Birth control pills appear to increase the risk of cervical cancer, but decrease the risk of ovarian and endometrial (lining of the uterus) cancer.
  • Data about their effect on breast cancer risk are not clear.
  • Women with migraine headaches also appear to have an increased risk of blood clots when taking the pill, particularly women over age 35.

Other health risks of the Depo-Provera shot

What are other birth control options?

There are many different kinds and choices of birth control to prevent becoming pregnant, for example, hormonal, methods like birth control pills, and birth control shots.

Other birth control methods include:

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Medically Reviewed on 3/3/2023
What are the different types of birth control? NIH. Jan. 31, 2017. <>.

Learn About Birth Control. Planned Parenthood. 2020.