Contraceptive Pearl: Contraception During COVID-19: Self-Administered Progestin Injection: Depo SubQ
Depot medroxyprogesterone acetate (DMPA) can be prescribed as a subcutaneous injection that patients give themselves at home. The self-administered version helps patients avoid the need for office visits during the COVID-19 pandemic. This method, also known as Depo SubQ, contains the same hormone, works in the same way, and has the same medical eligibility criteria as the in-office injection. Depo SubQ has a smaller needle (28 gauge x 3/8 inch) on a pre-filled, single-use syringe and is meant to be injected into the thigh or abdomen. It contains about 30% less progestin than the in office form.
While Depo SubQ was approved by the FDA in 2004, its use has been limited, possibly due to clinicians’ concern about patients’ ability to inject the medication correctly. A review of six studies with a total of 3,851 participants concluded that participants who self-administered Depo had a higher rate of continuation at one year than did participants who got injections at a medical office. There was no difference in pregnancy rates across study arms. Although the overall rate of side effects was similar in each group, the rate of local injection reactions was higher among participants who self-administered Depo. All six studies involved in-person training in subcutaneous injection technique.
During the COVID-19 pandemic, many of our patients wish to begin or continue Depo while avoiding the risk of entering a medical office. Self-administered Depo has distinct advantages for such patients. A Depo User Guide, linked below, has step-by-step instructions for patients to self-administer.
We would love to hear from you about the resources you need and the questions you have during this time. Please feel free to reach out to firstname.lastname@example.org.
Bedsider Depo SubQ: The Do-It-Yourself Birth Control Shot
The Shot (Depo Provera) User Guide
Contraceptive Pearl: The Shot (Depo Provera) 101
Pfizer Instructions for Use of Depo-SubQ Provera 104
Kennedy CE, Yeh PT, Gaffield ML, Brady M, Narasimhan M. Self-administration of injectable contraception: A systematic review and meta-analysis. BMJ Glob Health. 2019 Apr 2;4(2)e001350. doi: 10.1136/bmjgh-2018-001350.
Morse J, Slough L. Depo SubQ: The do-it-yourself birth control shot, Bedsider. 2015. https://www.bedsider.org/features/789-depo-subq-the-do-it-yourself-birth-control-shot.
The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.