For millions of women worldwide, the depo contraception injection—commonly known as Depo-Provera—offers a convenient, long-acting form of birth control. Administered every 12 to 13 weeks, this progestin-only shot promises high efficacy, with a failure rate of less than 1% when used correctly. For me, it was a choice I made 14 years ago, seeking a hassle-free way to manage contraception. Little did I know that staying on it for over a decade—far beyond what some guidelines suggest as a maximum of two years—would leave me grappling with bone problems and infertility. This is my story, and a deeper look into what the depo shot entails, its risks, and why time limits matter.

What Is the Depo injection and How Does It Work?

Depo-Provera is a hormonal contraceptive that delivers a synthetic form of progesterone, called medroxyprogesterone acetate, into the body via an injection in the arm or buttocks. For many, its appeal lies in its simplicity: no daily pills, no devices to insert—just a quick visit to a healthcare provider every three months.

When I started the depo injection at the age of 17, it felt like a perfect fit. I tried many different contraceptives and they didn’t agree with me. My nurse at the time didn’t mention a time limit, and over the years, as I moved between surgeries, no one flagged that 14 years might be excessive. It wasn’t until recently, when I started experiencing chronic joint pain and learned I couldn’t conceive, that I began to connect the dots.

The Two-Year Limit: Fact or Misunderstanding?

You might be wondering: is there really a two-year maximum for the depo injection? The answer is nuanced. In 2004, the U.S. Food and Drug Administration (FDA) added a “black box” warning to Depo-Provera’s labelling, cautioning that prolonged use—specifically beyond two years—could lead to significant bone mineral density (BMD) loss. The warning stemmed from studies showing that the shot’s suppression of estrogen (a hormone critical for bone health) could weaken bones over time, increasing the risk of osteoporosis or fractures later in life. The FDA advised that Depo-Provera should only be used as a long-term contraceptive if other methods were inadequate, and that its use should be reassessed after two years.

However, this isn’t a strict “maximum” enforced universally. In practice, many healthcare providers weigh the risks and benefits on a case-by-case basis. Some women stay on it for 5, 10, or even more years without issue—if they’re monitored and informed. For me, that monitoring never happened. No one suggested bone density scans or calcium supplements, and the two-year mark came and went without a conversation. Looking back, I wish I’d known to ask.

Bone Problems: A Silent Side Effect

A visit to an orthopaedic specialist revealed the truth: my bone density was alarmingly low for my age, bordering on osteopenia, a precursor to osteoporosis. The doctor asked about my medical history, and when I mentioned 14 years on Depo-Provera, his eyes widened. “That’s a long time,” he said, explaining that the injections estrogen suppression likely contributed to my bone loss.

Research backs this up. Studies, like those cited by the National Institutes of Health, show that women on the depo injection can lose 5-7% of their bone density within two years, with losses compounding over time. While some recovery is possible after stopping the shot, prolonged use—like mine—can make full restoration unlikely. Now, I’m on a regimen of vitamin D, calcium, but the damage feels like a permanent mark of those 14 years.

Infertility: An Unexpected Consequence

Perhaps the most devastating blow came when testing revealed that my ovaries weren’t functioning as they should. My doctor suspects that years of suppressed ovulation from the depo shot may have disrupted my hormonal balance long-term. Unlike other contraceptives, where fertility typically returns within weeks or months, the depo shot’s effects can linger. For some, ovulation resumes within 6-12 months of stopping; for others, it can take years—or, in rare cases like mine, not return fully.

There’s no definitive proof that 14 years on the shot caused my infertility—other factors could be at play—but the correlation is hard to ignore. Studies suggest that prolonged use can delay fertility, and anecdotal reports from women online echo my experience. I stopped the injections around a year ago, hoping my body would rebound, but so far, there’s little change. The regret is overwhelming: if I’d switched methods years ago, might I have preserved my chance to conceive?

Why Didn’t Anyone Warn Me?

Reflecting on 14 years, I’m left wondering how this happened. Was it a failure of communication? A gap in oversight? The depo shot isn’t inherently dangerous—millions use it safely—but its long-term risks require proactive management. Guidelines from organizations like the World Health Organization emphasize informed consent and regular check-ins, yet I slipped through the cracks. Perhaps I should’ve researched more myself, but I trusted my providers to guide me.

Moving Forward: Awareness and Advocacy

My story isn’t unique. Online forums and studies hint at others facing similar fallout from extended Depo-Provera use—bone issues, fertility struggles, and a sense of betrayal. If you’re on the depo injection or considering it, here’s what I’d urge: ask about time limits, demand bone density checks if you stay on it long-term, and discuss fertility goals with your doctor early. The depo shot can be a great tool, but it’s not one-size-fits-all forever.

Anonymous Article – Thank you so much for such a great and personal piece. We are sure this will bring awareness and information to so many women. This is hugely appreciated.