Depo Provera Administration and Management

Administration Guidelines

The Centers for Disease Control and Prevention recommends that Depo Provera should be administered every 3 months (13 weeks) with injections allowed up to 2 weeks late (15 weeks from last injection) without requiring additional contraceptive protection, and both provider-administered and self-administered subcutaneous formulations are recommended options for injectable contraception 1, 2, 3, 4
Self-administered subcutaneous DMPA-SC is now recommended as an additional approach that can improve contraceptive access and increase reproductive autonomy, according to the Centers for Disease Control and Prevention 1, 2, 3

Critical elements for self-administration include instruction on self-injection technique, proper sharps disposal guidance, access to follow-up care, reinjection reminders, and administrative issues, as recommended by the Centers for Disease Control and Prevention 1, 3
Patients should be encouraged to contact a healthcare provider to discuss side effects, change methods, or address injection concerns, according to the Centers for Disease Control and Prevention 2, 3

For spotting or light bleeding, NSAIDs for 5-7 days may be considered, as recommended by the Centers for Disease Control and Prevention 5

The injection can be given up to 2 weeks late (15 weeks from the last injection) without requiring additional contraceptive protection 6
Self-administration of DMPA-SC is now recommended as an additional approach to deliver injectable contraception 7, 8
Self-administered DMPA-SC has been shown to have higher continuation rates compared with provider-administered DMPA 7

ACOG does not recommend limiting use to 2 years as the benefits of preventing unwanted pregnancy generally outweigh the risks of bone density loss 9
For patients using DMPA beyond 2 years, counseling about measures to promote skeletal health is recommended, including daily intake of 1300 mg calcium and 600 IU vitamin D, regular weight-bearing exercise, and smoking cessation 9
Return to fertility may be delayed for 9-18 months after discontinuation 9, 10