This sheet is about exposure to depot medroxyprogesterone acetate in pregnancy and while breastfeeding. This information is based on available published literature. It should not take the place of medical care and advice from your healthcare provider.

What is depot medroxyprogesterone acetate?

Depot medroxyprogesterone acetate is the injectable (given by shot) form of a lab-made hormone called medroxyprogesterone acetate. It has been used to prevent pregnancy (as birth control). Depot medroxyprogesterone acetate can also be used to treat some problems linked to a person’s period (menstrual disorders) and, at high doses, can be used to treat certain types of cancer. This fact sheet will cover the use of the depot medroxyprogesterone acetate shot for birth control. Depot medroxyprogesterone acetate is not the same as oral birth control pills (pills taken by mouth), which contain other hormones. Depot medroxyprogesterone acetate is sold under the brand name Depo Provera®.

I am taking depot medroxyprogesterone acetate, but I would like to stop taking it before getting pregnant. How long does the drug stay in my body?

People eliminate medication at different rates. In healthy adults, it takes 120 to 200 days, on average, for most of the depot medroxyprogesterone acetate to be gone from the body.

I take depot medroxyprogesterone acetate. Can it make it harder for me to get pregnant?

Depot medroxyprogesterone acetate is a form of birth control and is expected to lower the chance of getting pregnant. After stopping depot medroxyprogesterone acetate, fertility may take time to come back, but is expected to return for most people.

Does taking depot medroxyprogesterone acetate increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Use of depot medroxyprogesterone acetate is not expected to increase the chance of miscarriage.

Does taking depot medroxyprogesterone acetate increase the chance of birth defects?

Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. The majority of studies have not found a higher chance of birth defects with exposure to depot medroxyprogesterone acetate.

Does taking depot medroxyprogesterone acetate in pregnancy increase the chance of other pregnancy-related problems?

Studies have not been done to see if depot medroxyprogesterone acetate increases the chance for pregnancy-related problems such as preterm delivery (birth before week 37). Two studies reported a link to low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth), while another study did not.

Does taking depot medroxyprogesterone acetate in pregnancy affect future behavior or learning for the child?

Studies have not been done to see if depot medroxyprogesterone acetate can cause behavior or learning issues for the child.

Breastfeeding while taking depot medroxyprogesterone acetate:

Depot medroxyprogesterone acetate gets into breast milk in small amounts and is not expected to negatively affect a child’s long-term growth and development. According to the World Health Organization (WHO), use of depot medroxyprogesterone while breastfeeding is usually not recommended less than 6 weeks after the baby’s birth. But the benefit of using the medication and breastfeeding your baby may outweigh possible risks. Your healthcare providers can talk with you about using depot medroxyprogesterone acetate and what medication is best for you. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a male takes depot medroxyprogesterone acetate, could it affect fertility or increase the chance of birth defects?

Studies have not been done to see if depot medroxyprogesterone acetate could affect male fertility (ability to get partner pregnant) or increase the chance of birth defects above the background risk. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

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 [PubMed: 11502302]
• Borgatta L, et al. 2002. Pregnancies diagnosed during Depo- Provera use. Contraception. Sep;66(3):169-72. [PubMed: 12384205]
• Callahan R et al. 2015. Ectopic pregnancy with use of progestin-only injectables and contraceptive implants: A systemic review. Contraception 92(6):514-22. [PubMed: 26363431]
• 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. [PubMed: 6126406]
• Deshmukh P, Antell K, Brown EJ. 2017. Contraception Update: Progestin-Only Implants and Injections. FP Essent.. 462:25-29. [PubMed: 29172413]
• Gray RH and Pardthaisong T. 1991. In utero exposure to steroid contraceptives and outcome of pregnancy. Am J Epidemiol 134:795-803. [PubMed: 1835282]
• Gray RH, Pardthaisong T. 1991. In utero exposure to steroid contraceptives and survival during infancy. Am J Epidemiol; 134:804-811. [PubMed: 1835283]
• Gu YQ, et al. 2004. Male hormonal contraception: effects of injections of testosterone undecanoate and depot medroxyprogesterone acetate at eight-week intervals in chinese men. J Clin Endocrinol Metab. 89(5):2254-62. [PubMed: 15126550]
• Hogue CJ. 1991. Invited commentary: the contraceptive technology tightrope. Am J Epidemiol 134: 812-815; author response 816-817. [PubMed: 1835284]
• Jaffe B et al. 1990. Health, growth and sexual development of teenagers exposed in utero to medroxyprogesterone acetate. Paediatr Perinat Epidemiol 4:184-95. [PubMed: 2362875]
• Jimenez J et al. 1984. Long-term follow-up of children breast-fed by mothers receiving depotmedroxyprogesterone acetate. Contraception 30:523-533. [PubMed: 6241560]
• Koetsawang S, et al. 1982. Transfer of contraceptive steroids in milk of women using long-acting gestagens. Contraception 25:321- 331. [PubMed: 6213373]
• 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. [PubMed: 1387602]
• Pardthaisong T, Gray R. 1988. Steroid contraceptive use and pregnancy outcome. Teratology 38:51-58 [PubMed: 2845595]
• 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. [PubMed: 26410174]
• Ratchanon S and Taneepanichskul S. 2000. Depot medroxyprogesterone acetate and basal serum prolactin levels in lactating women. Obstetrics & Gynecology 96(6):926-8. [PubMed: 11084179]
• Saxena BN et al. 1977. Levels of contraceptive steroids in breast milk and plasma of lactating women. Contraception 16:605-613. [PubMed: 606500]
• Virutamasen P et al. 1996. Pharmacodynamic effects of depot-lprogesterone acetate (DMPA) administered to lactating women on their male infants. Contraception 54:153-157. [PubMed: 8899256]
• World Health Organization. 2016. Resource chart medical eligibility contraceptives - FHI 360. (n.d.). https://www​.fhi360.org​/sites/default/files​/media/documents/resource-chart-medical-eligibility-contraceptives-english.pdf.
• Yovich JL, et al. 1988. Medroxyprogesterone acetate therapy in early pregnancy has no apparent fetal effects. Teratology 38:135-144. [PubMed: 3175947]

“OTIS/MotherToBaby encourages inclusive and person-centered language. While our name still contains a reference to mothers, we are updating our resources with more inclusive terms. Use of the term mother or maternal refers to a person who is pregnant. Use of the term father or paternal refers to a person who contributes sperm.