Sayana Press vs Depo-Provera; what is the best contraceptive injection?

Reviewed: April 1, 2021
Depo -Provera and Sayana Press are similar in many ways, but what are the differences?

The contraceptive injection is a popular contraceptive, and because of its longevity and practicality, it is a firm favourite amongst many women.

So which is the best contraceptive injection?

There are two different types of injection, Depo-Provera and Sayana Press. These two contraceptives have very similar side effects and method of action, however, differ when it comes to how they are administered. This post will explain everything you need to know.

What is Depo-Provera?

Depo-Provera is a brand name for medroxyprogesterone acetate (DMPA). A contraception injection that contains the hormone progestin, a synthetic form of the natural hormone progesterone. It is a highly effective method of preventing pregnancy and must be injected every 13 weeks. It works by suppressing ovulation and keeping your ovaries from releasing an egg, as well as thickening cervical mucus to keep sperm from reaching the egg.

What is Sayana Press?

Sayana Press is another brand of injection contains medroxyprogesterone acetate. Similarly it works by preventing ovulation and thickening cervical mucus. It should be administered every 13 weeks.

How effective is the contraceptive injection?

Both contraceptive injections are 99% effective and therefore highly effective methods of contraception. However the percentage decreases if you do not receive the injection at the right time.

How do I use Depo-Provera and Sayana Press?

Depo-Provera must be injected by a health care provider. Your doctor or nurse will check your medical history and make sure that you’re not pregnant.

You will be given the injection as you would a standard jab – Depo-Provera is injected into a muscle, usually in your buttocks and can also sometimes be given in the arm.

Sayana Press is injected beneath the skin at the front of the thigh or abdomen. It’s possible for you to be taught how to inject Sayana Press yourself at home but not all GPs and clinics currently offer this.

After the injection has been given you only need to go back to your doctor or nurse if you have any problems or when you need a new injection. Both the Depo-Provera and Sayana Press are given at intervals of 13 weeks and can be administered up to 7 days late, so 14 weeks after the last injection, without the need for additional contraceptive precautions (although this is outside the product license for Depo-Provera). If you are using the Sayana Press (which you inject yourself at home) you only have to go back to the clinic annually because you will be given a years supply. 

You can have the injection at any time in your period cycle. If you have it within the first five days of your cycle, you will be protected from pregnancy straight away. Any other time in your cycle and you’ll need to use condoms or other contraception for seven days.

You can have the injection straight after giving birth, even if your are breastfeeding, or after having an abortion or miscarriage.

How do I stop using Depo Provera and Sayana Press?

To stop, all you need to do is not have your next injection – if you don’t want to get pregnant then you should use another method of contraception from the day that your injection would’ve been due.

However, a word of caution about the contraceptive injection – it can take several months and even up to a year for your fertility and menstrual cycle to return to normal. If you are considering having a baby in the near future the injection may not be the best choice of contraception for you. Check out this blog about a user’s experience of coming off the injection with some insights from our resident GP Dr Mel.

You can also check out our survey results to see how long it took most women’s cycles to return to their definition of ‘normal’ after their injection, and learn about effects they’ve experienced.

Sayana Press and Depo Provera side effects

Both contraceptive injections have very similar side effects.

The main side effects include:

  • change to your periods or bleeding pattern
  • weight gain
  • a reaction at the injection site
  • hair loss
  • headaches
  • mood changes
  • decrease in sex drive

The side effect most noted by Lowdown users was 62% of Sayana Press users said it stopped there periods, compared to 71% of Depo-Provera.

Use of the contraceptive injection is associated with a small loss of bone mineral density, which is usually recovered after stopping. Women using the injection who wish to continue should be reviewed every 2 years to assess their individual situation, and to discuss the benefits and potential risks.

Less common side effects of this contraceptive injection include:

  • acne
  • sore breasts
  • hot flushes
  • insomnia
  • achy joints
  • nausea
  • vaginal dryness and irritation

Though rare, serious side effects can occur. You should seek immediate medical attention if you start having the following symptoms:

  • major depression
  • pus or pain near the injection site
  • unusual or prolonged vaginal bleeding
  • yellowing of your skin or the whites of your eyes
  • breast lumps
  • migraines with aura, which is a bright, flashing sensation that precedes migraine pain


What do our users say about Depo Provera?

“The contraceptive injection turned me insane! I noticed a change in mood within a matter of hours and was crying at daytime TV. The side effect lasted the full 3 months of the injection cycle and about another month after I’d come off it. I had bad mood swings and felt extremely emotional almost all the time! Also I couldn’t walk up the stairs after I had the injection, as it is injected at the top of your thigh/bum. I could feel the gel slightly through the skin too.”

“Years on injections Loved the ease & convenience of no periods, no hormonal mood swings But after ongoing years of also having lower back issues of pains & cramps turns out it was the injection! Doctors didn’t believe me and I even went on to have the injection in the arm to rule out any tissue damage from having the injection in the bum! Don’t use if you’re planning on starting a family in the very near future either. It took a full year for my periods to return after the last injection. Post children I gave it one more go to see if it was any different post children. But the back pain returned 24hrs after injection!! Have been off the injection for 4 years and zero pain!”






Reviewed and edited on 01/04/21 in line with our content policy.

This guide was brought to you by The Lowdown. We are the world’s first contraception review platform, providing real-life experiences from thousands of reviews collected from our community of men and women.

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