Does the Depo Shot Make Your Joints Hurt? A Scientific Review

October 9, 2025 •

4 min read

Joint pain is listed as a less common or common side effect of medroxyprogesterone, the active ingredient in the Depo-Provera shot [1.2.1, 1.2.5, 1.3.1]. If you're asking 'Does the depo shot make your joints hurt?', the answer is complex and linked to the shot's primary mechanism.

Quick Summary

The Depo-Provera shot can cause joint pain, a side effect listed by medical sources [1.2.2, 1.3.1]. This is largely attributed to its effect on estrogen levels, which can lead to a significant loss of bone mineral density, potentially causing aches and increasing fracture risks [1.4.7, 1.5.1].

Key Points

Direct Side Effect: Joint pain (arthralgia) is a recognized, though less common, side effect of the Depo-Provera shot [1.2.1, 1.3.1].
Hormonal Mechanism: The shot works by suppressing estrogen, a hormone vital for maintaining bone mineral density (BMD) [1.5.1, 1.4.7].
Bone Density Loss: A major concern is the significant loss of BMD with prolonged use, which led to an FDA black box warning [1.4.6, 1.4.7]. This loss can indirectly contribute to joint and bone pain.
Limited Long-Term Use: Due to bone health risks, the FDA advises against using the Depo shot for more than two years unless other methods are unsuitable [1.8.5].
Reversibility Is Not Guaranteed: While BMD can recover after stopping the shot, the recovery may be partial, especially for long-term users or those who started as teens [1.8.2, 1.8.5].
Management is Key: Managing pain and bone health involves a diet rich in calcium and Vitamin D, weight-bearing exercise, and avoiding smoking [1.3.6, 1.8.5].
Consult a Doctor: Anyone experiencing joint pain on the Depo shot should consult their healthcare provider to discuss management and alternative contraception [1.4.7].

What is the Depo-Provera Shot?

The Depo-Provera shot, the brand name for medroxyprogesterone acetate, is an injectable contraceptive that provides pregnancy prevention for three months per injection [1.7.6]. It is a progestin-only hormonal method that works by inhibiting the secretion of gonadotropins, which stops ovulation (the release of an egg from the ovaries) and thickens cervical mucus to prevent sperm from reaching an egg [1.5.4]. Its convenience makes it a popular choice for many, but it's essential to understand its full side effect profile, which includes potential impacts on the musculoskeletal system [1.7.4].

The Link Between the Depo Shot, Estrogen, and Joint Pain

The primary mechanism of the Depo-Provera shot involves suppressing ovulation, which in turn significantly reduces the body's circulating estrogen levels [1.5.1, 1.5.5]. Estrogen is a crucial hormone for maintaining bone strength and density [1.4.7]. When estrogen levels decrease, bone metabolism changes to accommodate this lower level, leading to a loss of bone mineral density (BMD) [1.8.2].

This loss of BMD is a major concern and is the subject of an FDA "black box" warning, the most serious type of warning, on the product's label [1.4.7]. The warning highlights that prolonged use of Depo-Provera (more than two years) can lead to significant bone density loss, which may increase the risk of osteoporosis and fractures later in life [1.2.6, 1.4.6]. Joint pain (arthralgia) and backache are listed as known, though less common, side effects of the injection [1.2.1, 1.3.1]. This pain can be an indirect consequence of these changes in bone health and hormonal shifts. While the direct causation for every case of joint pain isn't always clear, the physiological changes induced by the shot provide a strong link.

Scientific Evidence and Medical Guidance

Numerous studies and health organizations have documented the effects of Depo-Provera on bone health. Clinical studies show that women using the shot for up to five years can experience a 5-6% decrease in BMD in the spine and hip [1.8.2]. This loss is most pronounced in the first two years of use [1.8.2].

FDA Black Box Warning: The FDA recommends that Depo-Provera not be used as a long-term birth control method (longer than two years) unless other methods are considered inadequate [1.8.5].
Vulnerability of Adolescents: The bone density loss is of particular concern for adolescents and young adults who are in a critical period of bone accretion. Using the shot during these years may reduce peak bone mass, which is a key factor for lifelong skeletal health [1.5.4, 1.4.1].
Reversibility: For many women, the loss of BMD appears to be at least partially reversible after discontinuing the injections as ovarian estrogen production resumes [1.8.2]. One study noted that two and a half years after stopping, the average bone density of former users was similar to that of non-users [1.4.5]. However, recovery may not be complete, especially for those who used it long-term or started during their teen years [1.8.5, 1.8.6].

Comparison of Contraceptive Methods and Musculoskeletal Health

When considering birth control, it's helpful to compare the potential side effects of different methods. Not all hormonal contraceptives impact bone density in the same way.


Contraceptive Method	Primary Hormone(s)	Impact on Bone Mineral Density (BMD)	Associated Joint Pain Risk
Depo-Provera Shot	Progestin-only (Medroxyprogesterone)	Significant decrease; carries an FDA black box warning [1.4.6].	Listed as a known side effect [1.2.1, 1.3.1].
Hormonal IUDs (Mirena, etc.)	Progestin-only (Levonorgestrel)	Unlikely to have a significant impact on bone health [1.8.5].	Not commonly cited as a primary side effect.
Copper IUD (Paragard)	Hormone-free	No impact on BMD.	Can increase cramping and pelvic pain, but not system-wide joint pain [1.7.5].
Combination Pills	Estrogen and Progestin	No research has found a reduced bone density risk in adult women [1.8.5].	Some studies suggest estrogen may reduce joint pain [1.6.2].
Progestin-Only Pills	Progestin-only	Not generally a concern as they cause less suppression of estrogen than Depo-Provera [1.4.2].	Not a commonly reported side effect.
Contraceptive Implant (Nexplanon)	Progestin-only (Etonogestrel)	Studies suggest it does not significantly reduce bone density [1.8.5].	Not commonly cited as a primary side effect.

Managing Side Effects and When to See a Doctor

If you are experiencing joint pain while using the Depo-Provera shot, it is important to discuss it with your healthcare provider. They can help determine the cause and recommend management strategies.

Management Strategies:

Ensure Adequate Nutrition: A diet rich in calcium and vitamin D is essential for bone health. Good sources of calcium include milk, cheese, and leafy greens [1.3.6]. Your doctor may recommend supplements.
Regular Exercise: Engaging in regular weight-bearing exercises, such as walking, dancing, or strength training, can help promote bone strength [1.8.5].
Lifestyle Modifications: Limiting alcohol consumption and avoiding smoking are crucial, as these are risk factors for osteoporosis and can exacerbate bone loss from the Depo shot [1.4.4, 1.8.5].
Consider Alternatives: If the pain is significant or you have been on the shot for more than two years, discuss alternative contraceptive methods with your doctor [1.4.7]. Options like hormonal or copper IUDs, the implant, or pills may be more suitable [1.7.3, 1.8.5].

Conclusion

The evidence confirms that the Depo-Provera shot can indeed cause joint pain, which is linked to its significant impact on estrogen levels and bone mineral density [1.2.1, 1.4.7]. While the contraceptive is effective and convenient, its use, especially long-term, requires careful consideration of the risks, particularly the potential for bone loss [1.2.6]. Bone density loss is often partially or fully reversible after stopping the medication, but the recovery can be slow and may not be complete for everyone [1.8.2, 1.8.4]. Open communication with a healthcare provider is essential to monitor side effects, manage bone health through lifestyle choices, and decide on the most appropriate contraceptive method for your individual health profile.

For more information on the effects of medroxyprogesterone, you can review the patient information provided by Pfizer: https://labeling.pfizer.com/ShowLabeling.aspx?id=522

Frequently Asked Questions

While the Depo shot's primary long-term risk is bone mineral density (BMD) loss, this can increase the risk for osteoporosis and fractures [1.2.6]. The BMD loss may not be completely reversible, especially with use longer than two years or during adolescence [1.8.5]. This weakened bone structure is the primary long-term concern.

The decline in bone mineral density can begin within the first few years of use [1.8.2]. Joint pain is listed as a potential side effect, but the exact onset can vary from person to person [1.2.1].

As bone density begins to recover after discontinuing the shot, related pain may subside [1.8.4]. Studies show BMD levels can return to near-original levels after a few years off the medication [1.4.2]. However, the experience can vary among individuals.

All injectable contraceptives in the US market, like Depo-Provera and its generic forms, contain medroxyprogesterone acetate and carry similar risks of bone density loss and associated joint pain [1.7.6]. Other contraceptive forms, like IUDs or the implant, have a lower risk of this side effect [1.8.5].

To help protect your bones, ensure you have an adequate intake of calcium and vitamin D, engage in regular weight-bearing exercise, avoid smoking, and limit alcohol consumption [1.3.6, 1.8.5]. Discuss long-term use and bone density monitoring with your doctor [1.4.7].

Adolescence is a critical time for bone building (accretion). Using the Depo shot during these years can reduce the peak bone mass a person achieves, potentially increasing their risk for osteoporotic fractures later in life [1.5.4, 1.4.1].

The FDA recommends that women who need to continue using the Depo shot for longer than two years should have their bone mineral density (BMD) evaluated [1.8.2]. It is a discussion to have with your healthcare provider, especially if you have other risk factors for osteoporosis [1.4.7].