Switching From an Injectable to an Oral Contraceptive

Andrew M. Kaunitz, MD

Disclosures

July 29, 2003

Question

After a year of using injectable contraceptive (Depo-Provera), a patient wishes to switch to oral contraceptives. When is the optimal time to switch regimens? Does the patient have to take oral pills at once when she is still amenorrheic, or should she wait for the menses to return first?

Response from Andrew M. Kaunitz, MD

In women using depot medroxyprogesterone acetate (DMPA, or Depo-Provera) contraceptive injections, injections each 3 months are highly effective in preventing pregnancy. In women who wish to change from DMPA to another form of birth control, the new method should be started within 3 months (or 12-13 weeks) of the previous injection. This ensures that the patient is not pregnant at the time she initiates a new contraceptive method. With long-term use of DMPA, most users become amenorrheic. Menstrual status, however, does not determine when DMPA users should start a new birth control method.

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