The following is an earlier question and answer concerning this same subject:
Trigger Question: What is the latest information on the length of effectiveness of Depo-Provera injections?
Q: How long is a woman protected when using Depo-Provera? We have patients who frequently come in late for their shots and questions arise about when a pregnancy test is needed, when we should advise the use of Plan B and when to use a backup method.
17 weeks is the new WHO recommendation for the duration of Depo-Provera effectiveness.
Depo-Provera injections are effective for 13 plus 4 weeks or 17 weeks. Plan B might be suggested if unprotected sex happened more than 17 weeks after the last injection. Beyond 17 weeks, backup contraception would definitely be recommended.
This is the most recent guidance from the World Health Organization:
- DMPA may be provided anytime in the cycle
- Check pregnancy test +/- and offer emergency contraception if sex after last normal menses
- Instruct use of back-up method if necessary
- Instruct patients to return in 12-13 weeks
- Injections may be given earlier as needed
- Re-injections may be provided up to 17 weeks later
- Check pregnancy test if more than 17 weeks 0 days
FYI: HERE ARE THE CURRENT Grady FPC Protocol Changes from Dr. Carrie Cwiak:
} DMPA may be provided anytime in the cycle
◦ Check pregnancy test +/- offer EC if sex after last normal menses
◦ Instruct use of back-up method if necessary
} Instruct patients to return in 12-13 weeks
◦ Injections can be given earlier as needed
} Re-injections may be provided up to 17 weeks later
◦ Check pregnancy test if more than 17 weeks 0 days
} Medical Eligibility Criteria. Second edition, World Health Organization, Geneva, 2005. www.who.int/reproductive-health
} Selected Practice Recommendations. Second edition, World Health Organization, Geneva, 2005. www.who.int/reproductive-health
} Stewart FH, Harper CC, Ellertson CE, et al. Clinical breast and pelvic examination requirements for hormonal contraception. JAMA 2001; 285:2232-39
} Sneed R, Westhoff C, Morroni C, Tiezze L. A prospective study of immediate initiation of depot medroxyprogesterone acetate contraceptive injection. Contraception 2005; 71:99-103
} Nelson AL, Katz T. Initiation and continuation rates seen in 2-year experience with same day injections of DMPA. Contraception 2007; 75:84-7
} Steiner MJ, Kwok C, Stanback J, et al. Injectable contraception: what should the longest interval be for re-injections? Contraception 2008; 77:410-14
To learn more about the advantages and disadvantages of Depo-Provera injections, go to our website: www.managingcontraception.com and click on Choices. You can also order this wonderful new educational book from our website or by calling 404-875-5001. Do you have your copy yet?
Key Words: Depo-Provera injection, second shot, sex, ejaculated, protected, Plan B, pregnancy, World Health Organization