Progestogen-only long-acting injectable contraceptive
ATC code: G03AC06 (Medroxyprogesterone)
Intramuscular 150 mg or subcutaneous 104 mg injection every 3 months. Suppresses ovulation via gonadotropin suppression. Delayed fertility return – median 10 months after last injection. Reduces bone mineral density with long-term use – per black box, no more than 2 years without reassessment.
Second line
Contraception for women who find daily pills inconvenient and dislike implants or IUDs. Per SEGO 2023, second-line due to BMD reduction and delayed fertility return. Pearl Index 0.2 perfect-use. Especially valuable in endometriosis and sickle cell disease (reduces crises).
First line
Contraception during breastfeeding. MEC 2015 category 1 from day 1 postpartum. Does not reduce milk supply. RID about 1%, Hale L1. Good option if daily pill-taking is unacceptable.
Opens the checker prefilled with this drug. Pick the second one from your regimen.
Boxed warning
FDA black box: prolonged use beyond 2 years lowers BMD with possibly incomplete recovery. Use cautiously in teens and women at risk for osteoporosis.
Do not administer in pregnancy.
WHO MEC 2015 category 1 from day 1 postpartum. Does not reduce milk supply. Medroxyprogesterone RID about 1%, Hale L1.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Medroxyprogesterone acetate depot is evaluated for the following indications with varying evidence strength: Contraception (evidence tier A), Contraception during breastfeeding (evidence tier A). See the full indication matrix with dosing and citations above on this page.
Common side effects of Medroxyprogesterone acetate depot (≥ 1 in 100): Weight gain 2-5 kg, Amenorrhea (50% by year 1), Irregular bleeding in first 3-6 months, Headache, Decreased libido, Depressive episodes. See the Safety section for uncommon and serious reactions.
FDA category X. Do not administer in pregnancy.
WHO MEC 2015 category 1 from day 1 postpartum. Does not reduce milk supply. Medroxyprogesterone RID about 1%, Hale L1.
Medroxyprogesterone acetate depot is contraindicated in: Hypersensitivity; Pregnancy; Unexplained uterine bleeding; Breast cancer; Severe liver disease. Full list in the Safety section.
FDA black box: prolonged use beyond 2 years lowers BMD with possibly incomplete recovery. Use cautiously in teens and women at risk for osteoporosis.