Mass General Hospital

Harvard Medical School

Does Depo-Provera Cause Mood Changes?

Depo-Provera (DMPA), also known as the birth control shot, is a highly effective form of contraception that lasts for 3 months, and thus requires only 4 injections per year. DMPA contains a long-lasting form of depot medroxyprogesterone acetate that works as a contraceptive agent by preventing the ovaries from releasing an egg each month. Potential side effects of DMPA include bone density loss, weight gain, and mood worsening. Although depression is listed in the packet insert as a side effect of the injection, available research addressing this side effect are limited and contradictory.

In two older studies, between 1% and 5% of DMPA users reported experiencing depression or mood changes on the treatment, but these studies used brief non-standardized interviews. Three more recent studies have used more structured assessments of mood to evaluate whether there are mood effects of DMPA use.

The 2006 Bulletin of the American College of Obstetricians and Gynecologists states that DMPA does not appear to be associated with mood worsening. This is based primarily on a one large study of 495 women who chose to use DMPA. After 12 months, 34% of participants were still using DMPA, 44% had discontinued use, and 20% were lost to follow-up. Over the 12 month period, depression levels improved slightly in the women who continued using DMPA, and depression levels were unchanged in those who discontinued it.

It is important to note, however, that in this study women who discontinued DMPA had slightly higher baseline depression scores than continuers. Furthermore, one of the limitations of this study is that it did not provide any information as to why such a large proportion of women discontinued DMPA use. If a significant proportion of those who discontinued did so because of mood worsening, we cannot conclude that DMPA use has no impact on mood.

Of two other studies that have examined the relationship between DMPA use and depression, one found a negative effect on mood and the other reported no relationship. The first was a 3- year study of 183 women which found that women using DMPA had an increase in depressive symptoms when compared with women not using DMPA. The women who stopped using DMPA during the study had higher levels of depression immediately before or immediately after they discontinued DMPA than they had before starting DMPA. Levels of depression in this group dropped to those observed in non-DMPA users within several months of the discontinuation of DMPA.

The second study of 39 adolescents found that over 1 year of continued use, DMPA was not associated with any mood changes.

Although some women report mood worsening on DMPA, more research is needed to determine how common this side effect is and if women with a history of mood disroder are more susceptible to such a side effect. Women with a history of mood disorder should talk to their doctor about these risks and benefits before using DMPA.

One option for women considering DMPA who are concerned about side effects is to have a short trial of oral medroxyprogesterone acetate (Provera) – the same medication that is in the DMPA injection. The advantage of administering a short trial of oral medroxyprogesterone acetate is that, if there is an adverse reaction, the oral medication can be stopped immediately, whereas the side effects of the long acting DMPA injection may linger.

Adriann Kanarek-Farrell, BA
Hadine Joffe, MD, MSc

ACOG Practice Bulletin. No. 73: Use of hormonal contraception in women with coexisting medical conditions. Obstet Gynecol. 2006 Jun;107(6):1453-72.

Westhoff C, Truman C, Kalmuss D, Cushman L, Davidson A, Rulin M, Heartwell S. Depressive symptoms and Depo-Provera. Contraception 1998;57:237-40.

Civic D, Scholes D, Ichikawa L, LaCroix AZ, Yoshida CK, Ott SM, Barlow WE. Depressive symptoms in users and non-users of depot medroxyprogesterone acetate. Contraception 2000;61:385-90.

Gupta N, O’Brien R, Jacobsen LJ, Davis A, Zuckerman A, Supran S, Kulig J. Mood changes in adolescents using depot-medroxyprogesterone acetate for contraception: a prospective study. J Pediatr Adolesc Gynecol 2001;14:71-6.

Schwallie PC, Assenzo JR. Contraceptive use–efficacy study utilizing medroxyprogesterone acetate administered as an intramuscular injection once every 90 days. Fertil Steril 1973;24:331-9.

Fraser IS, Dennerstein GJ. Depo-Provera use in an Australian metropolitan practice. Med J Aust 1994;160:553-6.

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26 Responses to Does Depo-Provera Cause Mood Changes?

  1. Denise Ross September 21, 2008 at 3:29 pm #

    I took depo for about 4 years from the age of 17 until 21. I am a very negative person, and seem to get annoyed really easily. I didn’t notice it as much when I was younger, but that time in a young girls life is rather stressfull anyway. So I am not sure that they are related or not. I am 25 now and am really tired of being so irritable and can’t seem to do anything about it. I take some over the counter mood pills that help for the most part, but I am still a bit over the top when it comes to annoyances.

  2. sonya September 12, 2012 at 7:31 am #

    I am 40 and currently using depo. I had serious depression as a teenager, but have been stable for the last 25 years. Not anymore..I found myself visualling my own I would do it etc. the other day. I am rational enough to know that even though the feelings seemed real, that it was the drug causing the emotion. (please do not flood me with hotline advice. I added this experience to inform). I also have random weird cramps throughout my body. Not just old age pains! So, I chose depo b/c I have children and was afraid of doing anything “drastic” to my body until menopause..LOL that is truly a laugh considering where this drug has taken me. But no worries, as well as causing weird random bouts of depression, odd cramping..I have absolutely no interest at all in i guess the drug is working…oh and the 30 day period..that was awesome.

  3. Marie williams November 18, 2012 at 12:54 pm #

    Thank you Sonya and Denise , this irritability,(on top of my regular irritable self) has gotten in the way of my relationship, it is not worth it for me. All this time I thought is was just me being mean, I’m not usually mean, I have been on it for over 2 years, enough of the Depo, I’m taking something else!!

  4. MrsHmmz December 15, 2012 at 7:42 am #

    My own personal experience & anecdotal reports from people I have spoken to suggests that mood changes & reduced sex drive are incredibly common symptoms with Depo-Provera, so I find it very surprising there has not been more published evidence of this! I realise my sample could in no way be considered “scientific” but I can’t help but wonder how many women don’t report the adverse effects (nobody I’ve spoken to actually reported them) and just stop taking it. It seems the symptoms are often quite subtle and the women experiencing them only realise how bad they were feeling when they start to get better, or the effects are noticed more by the people who live with them than by the women themselves.

    My own experience was that I completely lost my sex drive & became almost devoid of emotion, apart from being irritable with my partner & children & having bouts of extreme sadness. I became so detached that I almost didn’t notice how bad it was, but my husband says I became cold & emotionless, almost like a robot. I knew that the Depo was making me feel bad, but it was only when the effects of the injection started to wear off that I really noticed how awful I had been feeling! I never reported these symptoms to my doctor & wasn’t asked about it, I just never went back for a second injection.

    The injection seems to be the only plausible explanation for this; nothing else was going on in my life at the time, I have never had a similar set of symptoms at any other point in my life, and they definitely started shortly after I had the shot then gradually faded away after 3 months.

    I do know that I seem to be quite sensitive to hormonal fluctuations (I get quite bad PMT, and I lost my sex drive whilst pregnant), which perhaps made me more prone to react badly to something like Depo Provera, but judging by the things I’ve heard from other people who’ve tried it I am far from being unusual in experiencing these side effects.

  5. Chloe December 27, 2012 at 11:36 pm #

    I am 23, and I have actually been on Depo since I am about 14 or 15. It’s been a long time. That makes it very difficult to compare the progression of my mood up to my current mood, to my previous mood. If I look back on that period of my life, I could say that I am prone to over-thinking and anxiety. I can drive myself mad with all these worst case scenarios that haunt my mind. sometimes I feel like I am living on a never ending rollercoaster, of indifference, sudden anger, frustration, sadness, hopelessness and an occasional break from it all thanks to a very very supportive boyfriend. My happiest moments are quite literally during and after sex, and sometimes after a work out, during moments of euphoria. Otherwise I am generally sad. I avoid large gatherings like the plague and I am incapable of maintaining friendships. I like to think that I am too old for an identity crisis but I often find myself infuriated against society and feel misunderstood.

    I wish I could find out what makes me that way. I cry very often, and even if I wait to be alone to cry, my boyfriend tells me he can actually smell it when he comes in the room if I’ve recently cried…It’s becoming difficult to hide.

    I wish there was away to find out whether this is a hormonal problem, a personality disorder or perhaps Depo, without consulting any professional. I’ve lost count of how many times I’ve tried using my benefits from work to contact a counselor, but was unable to speak when they contacted me back. I often completely avoid answering the phone when I know it’s the counseling agency calling back. I can’t do it.

  6. Iesha May 26, 2014 at 4:44 am #

    I started the depo shot on April 18th, ever since then I have noticed that I have been VERY EMOTIONAL crying late at night for no reason what so ever. I have never been more depressed before in my life. I wish I would have known the side affects before I got the shot. I feel like I’m a completely different person and no one understands why sometimes I’m happy then the next I feel like crying. I have also noticed I’m starting to become a lot more irritated than I used to be before, I absolutely hateeee the shot!!

  7. Bria H. June 12, 2014 at 1:28 pm #

    I would not recommend the shot to anyone! I received my first shot on may 28th. And ever since i have had nothing but trouble. I have endometriosis which is a chronic disease that can eventually cause issues with your whole reproductive system if a severe case. i have tried all methods of birth control (pills, implants, Iud’s) since getting my shot i have been experiencing depression, crying fits, im so irritable that i have pushed away everyone of the opposite sex. My sex drive is ZERO. My boyfriend doesnt even know what sex is anymore. In the short of time ive been on this shot my appetite has spiked. i didnt eat big meals before the shot & now i want to eat like im feeding twins. No matter how portioned or healthy i make my meal it seems like the food is never enough. ive gained weight already. I will not being getting a second shot. they dont warn you of the side effects before you get this. They kjust say its a good option for you. Well i call BS. STAY AWAY FROM THIS SHOT!

  8. Karey June 17, 2014 at 12:02 am #

    I have had 6 shots now about to get my 7th and I am hesitant because there is a week in between getting the shot and my next due time to get it, that I experience super PMS. I am tired and anxious and previously experienced basic lost of control on irritability. I started taking magnesium and Vitamin D to see if it helps with the mood swings and fatigue, but I would recommend fully researching this before taking this shot, I don’t think they have enough evidence to say what it’s long term effects are.

  9. Miranda July 20, 2014 at 1:29 pm #

    I took the shot for the first time on July 5 and from then on my mood has been going downhill from a very optimistic person to a bipolar wreck. It feels like all I want to do is lay in my bed and cry for days. I tend to hide it whenever my boyfriend’s around because I don’t want to talk about it because I can’t explain it, and Idon’t want to make it seem like it’s his fault for me not being happy because it’s definitely not. It also seems like I have lost my luster since takeing the shot because i’ve noticed my boobs have gotten saggy!!! Yes, saggy, and I’m only 18 years old!!! And I’ve gained alot of weight and I literally have the body of an old woman. I’ve been debating long and hard whether to keep getting the shot and hopefully see if my body will get used to the hormones, just stop the shot completely and pick another alternative, or just quit birth control overall. I just want to get out of this funk that I’m in!!

  10. Kim August 15, 2014 at 4:28 pm #

    I can’t say how happy I am that I found this page! I am 34, a diagnosed bipolar with anxiety and ADHD. I was essentially stable up until six months. That was when I stupidly took out my IUD and started on Depo. My life has been in shambles since then. I’ve constantly dealt with everything the other women stated. I thought I was losing my mind. I near lost my relationship multiple times. My children have suffered dearly because of my moods. Depo is poison and should not be administered to anyone! This has made my moods so severe I have even been suicidal at times. I absolutely cannot wait for this garbage to get out of my system!

  11. jj October 9, 2014 at 6:46 pm #

    My daughter is 15 and just got her 3rd shot. I asked her to try a different birth control as I have norice d her irratable emotional and mentally unstable. She would freak out for no reason and get physical with her siblings. Its almost like it has made her majourly bi-polar. Can’t reason with her when she is raging.

  12. Jazmine October 12, 2014 at 3:02 am #

    I had my first shot two weeks ago and I have never been so sad,depressed and overwhelmed. Tonight I called my husband because I was so scared of how depressed I was. This was my first and last time getting this shot I am an emotional wreck. I cried so much tonight my two year old said papa look at mama as soon as he walked in the door

  13. Melissa December 1, 2014 at 5:33 pm #

    I absolutely dislike I’m on the depo shot. I’ve told my OBGYN that I have turned into a B*TCH. They said if you feel like you want to kill someone let us know. REALLY…ok. I feel like killing you now let’s get me off the shot. They thought I was joking. I’m going to get a second opinion from another office. I don’t like being this way around my young children and my husband. In need of a change.

  14. Toni March 22, 2015 at 3:19 pm #

    I started the depo on Monday. I have been such a wreck and im only on day 6 and I feel like im acting myself destroy my own life from afar. I was researching this hoping that it is just a temporary effect and that it starts to dissipate. If anyone has some helpful hints please let me know.

  15. N.coleman April 14, 2015 at 7:31 pm #

    I started the depo 2 months ago and ever since then I’ve noticed my emotions are all over the place.Every day feels gloomy and I can’t remember the last time I’ve felt happy since I started this birth control. Every one warned me about it and said not to get it but I was so determined to get a birth control that really worked for me , now I do not recommend anyone To get the depo shot . Most of the time I feel sad , depressed , and cry because I feel like no one understands, and I have no reason as to why! Because don’t even understand , the only explanation is this Depo shot ! . The depo shot side effects will lead you into a bad depression .

  16. Lauren J April 18, 2015 at 1:22 pm #

    God, I didn’t know that depo could cause so many problems. My ob/gyn overlooked my high blood pressure and history of PTSD, gave me the shot, and I have had anxiety attacks and bouts of crying since I got the shot. I am now on blood pressure meds and wellbutrin, all because I got that shot. I am so upset at my doctor for toying with my health and life that way. I hope that once the depo cycles out of my system, I will be ok. It took me going back to my primary care provider to finally get a doctor to notice that my blood pressure and anxiety/depression are worsened because of that shot. Wish I had never agreed to get on birth control. But what was the outcome for people that stopped taking it?

  17. Alena April 21, 2015 at 3:33 am #

    I must be the only person on this page to NOT experience these negative side effects, but I’ve never expected to feel good all the time, life is life. PMS happens and it makes me wanna smash things, I never do, but it always makes me “fed up” with the world at large. Depo doesn’t do bad things to everyone. It’s the best option for my circumstance.

    I’ve used it several times throughout my life and never had issues with it. Now that I am a woman over 35 and have a near grown child, Depo is one of the safest options for me to use.

  18. Markita May 2, 2015 at 7:14 pm #

    I just started the depo shot almost a week ago and I have been super emotional! I’ve been crying at the drop of a hat. I feel like I’m on a emotional roll-a-coaster. My boyfriend noticed and said “Damn babe are you pregnant on something because you’ve been emotional a** F*** lately” then I realized like wow I have been like a for real cry baby which caused me to google “does the depo shot make you emotional” and found this page. I guess i’m somewhat relived to know it’s not just me.

  19. Katie May 12, 2015 at 6:23 pm #

    Since coming of my depo injection I’ve had pms to the extreme. …little things bother me for no reason… It’s so strange ? Has anyone else has this ?

  20. Helen May 14, 2015 at 3:29 pm #

    I just started on the depo last Friday .. 7 days ago and I was on it for about a year or two in 2010 and I didn’t feel anything back then but I also did not know how to listen to my body and notice the changes. Now I do. This is horrible I have never been so irritable in my life no wonder back then it destroyed my relationship. I’m glad my boyfriend is very understanding about my emotional rollercoaster. I didn’t even feel this way when I was pregnant. I feel like doing something extreme and then I’ll cry over something.. little nothing… I see the only way to get this out of my system is to have a blood transfusion… I have no patience. And I AM A VERY PATIENT AND LOVING PERSON. don’t do it.

  21. Shayna May 20, 2015 at 1:38 pm #

    Wow yes I had my son in dec. and had my first shot in February. My partner and I have noticed s HUGE change in my moods and “swings” would be putting it lightly !! It’s now 3 months later time for my my next injection and i do believe ILL PASS !!

  22. Ma'Kayla May 21, 2015 at 9:41 pm #

    I have been getting depo shot since I was 16. I am now 23. I have been suffering from depression and anxiety since I was 17. At first my depression wasn’t so bad. It was manageable and I could still go on with life. I even graduate from college but it was very tough. Eventually my depression continued to get worse and worse. I have been hospitalized 6 times and currently writing this while I’m at the emergency room for suicidal thoughts. Every one keeps asking why I’m sad and I repeatedly have to say I don’t know! I have taken all kinds of meds and even had ECT. Nothing seems to be making it even a little better. I’ve gotten to the point I feel like just crying, not being bothered, not motivated, unable to go to work due to fear of having a break down, incredibly sad, and thinking about death. Doing research, I realized the depo shot is the only thing that was started when I was 16 and I’ve still been taking it. I don’t have a menstrual at all and I’m sure that’s not normal for the female body. I just recently got the shot like 4 weeks ago. Wish I hadn’t but will not be getting another.

  23. kate May 23, 2015 at 7:04 am #

    I have been on this for three months.. and it’s been the WORST experience of my life. Ive been so horrible and just sad.. it’s ruined my relationship (yep.. three months it ruined it and now he’s moved two states away from me..) but tonight I finally got my period and now I’m feeling like a weight has lifted off my shoulders. I’m still sad and all that bullwhip but now I’m looking forward to not going on anything and going oh natural!

    Never again will I go on it. My Dr suggested I do it for one more shot but id rather get my life back on track!


    Stuff that.

  24. Fiona June 16, 2015 at 2:01 am #

    I got my first shot 2 months ago, since then I have been falling into depression, pushed everyone away and ruined my shot at a relationship with a really awesome guy. I cry nearly every day and being around anybody is almost too much to handle. I didn’t understand and barely noticed until it got pointed out to me and now I feel like crap for being moody and snappy at everybody. I wish that I had done research, especially because being on just birth control pills made me moody this is 10x worse.

  25. V June 19, 2015 at 5:37 pm #

    To all the women who have experienced side effects including depression, irritability, weight gain and all of the above.

    I was given depo by my doctor and she neglected to share with me the side effects. I’ve had and am still having depression…..very bad depression and did not know what was going on until yesterday when my doctor told me the cause of my depression and irregular bleeding was the depo shot.

    The past 6 months while I was on depo was the hardest and most difficult time of my life and I am sure that there are many women who do not come forth and relay this to the public or doctors. Those women probably don’t know that there actions and hardships they are experiencing is probably because of this terrible drug.

    My doctor stated that it will be out of my system in a couple weeks and I am devasted and mad and upset that I was given this drug without being informed of the side effects. In my opinion, this drug should be banned. The effects are supposed to last 11-14 weeks per shot and in your system a couple weeks thereafter.

    I have ready many forums of women who have side effects and their problems associated with this drug. When I am completely rid of this drug in my system and able to think correctly, I will look into a class action lawsuit against the makers of this drug and possibly against my doctor. It is unspeakable what this drug has done to me physically and mentally. It needs to stop!

    I wish all the woman good luck and to be strong because things will get better once this drug is out of your system! Drink plenty of fluids, have a good diet and exercise. Take care of yourselves and don’t let this drug beat you! Be strong!

  26. Liz July 12, 2015 at 12:46 pm #

    10 yrs ago after giving birth to my son I developed severe anxiety, PND and eventually OCD. 18 months of hell. 3 months ago I stopped the depro shot after a year of using it. Slowly the anxiety crept in, then depression and with the full force of 10 yrs ago, OCD. The past 3 months have been tragic. Am now taking a high dose of a SSRI to try and get me back on track. I know its the depro shot.

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