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Is Bleeding or Spotting on the Birth Control Shot Normal?

Spotting and bleeding when on the birth control shot is a common side effect that is often experienced by users within the first six to twelve months of use. Depo-Provera, the birth control shot, delivers a high dose of progestin so women can prevent pregnancy. Progestin is a synthetic version of the sex hormone progesterone, which naturally occurs in the body. Depo-Provera shots have also been used to treat conditions linked to the reproductive system, including endometriosis.

How does the shot work to prevent pregnancy?

The shot works in multiple ways to help reduce your risk of becoming pregnant. It prevents the release of eggs from your ovaries so that fertilization does not occur. Progestin will also increase the production of mucus on your cervix. This will create a sticky buildup that makes it difficult for sperm to travel to the uterus.

The final way in which the shot prevents pregnancy is by thinning the lining of the tissue on your uterus. This action works as a fail-safe. In the off-chance that you ovulate and a sperm fertilizes it, the egg will have a difficult time implanting on the uterus. With the birth control shot, you will experience a 99% effectiveness rate if taken according to schedule. It is considered one of the most effective birth control methods available and the ideal option for women who have a harder time with a daily medication routine.

What kind of bleeding might you experience while on the birth control shot?

Irregular bleeding is one of the most common side effects reported by women when they first use the shot, but it is a symptom that often goes away over time. Women may experience three types of regular bleeding:

  • Breakthrough bleeding: When on the shot, you may have spotting or bleeding in between your regular periods. This usually occurs for as long as six months to the first year after treatment has started, though it will typically cease to occur if shots are obtained on a regular schedule.
  • Heavy periods: For some users, the hormone shot can make periods last longer and create a heavier flow. This is one of the least common types of irregular bleeding experienced with the shot and typically resolves within several months of use.
  • No periods, or lighter less frequent periods: A large percentage of women report having no periods after they have used the birth control shot for at least a year. For those who don’t have a cessation of their period, they are likely to start seeing much lighter periods after 12 months. Both lighter periods and the absence of periods are completely normal and safe.

What causes irregular bleeding with use?

Irregular bleeding and the other symptoms associated with the birth control shot are caused by the high dose of progestin that is delivered in each injection. Since a higher level of hormones has been introduced into your body, your body will need time to acclimate and adjust to these new levels. This is why the side effects are most pronounced in the first six months. By the third or fourth injection, your body is better prepared to accept the larger dose of progestin.

When should irregular bleeding be a cause for concern?

While heavy bleeding may be completely normal, if you seem to be bleeding heavily for more than two weeks, you should contact your healthcare provider. They will help you determine if this issue is problematic or just a normal part of your body’s reaction to the shot. They may also want to check your iron levels to make sure they are still sufficient.

Treatment for heavy bleeding while on the birth control shot

While there is no evidence of regular treatments to stop bleeding while on the shot, your healthcare provider may try a few medications to help lessen the symptoms. NSAID, such as ibuprofen, may be taken for five to seven days and may help the heavier bleeding to stop. Anti-inflammatory medications, such as Mefenamic acid may also be prescribed for short-term use in lieu of ibuprofen. This is not often used as a long-term solution because it can carry risk factors of high blood pressure, heart attack, and stroke with heavy use.

Another treatment that your healthcare provider may order is supplemental estrogen. This form of treatment is believed to be able to promote coagulation and tissue repair. While this will not reduce the effectiveness of the birth control shot, it can cause estrogen-related side effects.

Some doctors have also prescribed medications that have been approved by the FDA in the past decade. These are typical treatments that are used in the treatment of heavy menstrual bleeding, such as Tranexamic acid. This medication sometimes will cause minor side effects such as back pain, headache, stomach cramping, sinusitis, anemia, fatigue, and muscle and joint pain.

Bleeding after birth control shot use

The hormones you receive from the Depo shot will be effective in your body for three months. After this time frame, you still may experience bleeding for several weeks or even months after terminating use. This is normal and will usually completely rectify within six months to a year after use has been discontinued.

Irregular bleeding when on the birth control shot is completely normal. If you are concerned about it, or other side effects, you should discuss with your health provider what you are experiencing. While it can take several months to a year for the side effects of the shot to subside, it is an extremely effective birth control method.

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