Microgestin vs. Depo-Provera

See how Microgestin and Depo-Provera compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Microgestin is a daily combination pill with estrogen and progestin, while Depo-Provera is a progestin-only injection given every three months.

  • Depo-Provera carries a boxed warning for bone density loss with long-term use, while Microgestin carries warnings about blood clot risk, especially in smokers over 35.

  • Microgestin's effects stop quickly once you stop taking it, while Depo-Provera's effects and any side effects can linger for months after the last injection.

Microgestin vs. Depo-Provera Drug Summary

Microgestin

Microgestin is a combination oral contraceptive containing norethindrone acetate and ethinyl estradiol, a progestin and an estrogen. It's taken once daily, with iron or placebo tablets during the last week of the 28-day pack. It has been available since 1968.

Depo-Provera

Depo-Provera is a progestin-only contraceptive containing medroxyprogesterone acetate. It's given as an intramuscular injection once every three months at a doctor's office. It has been FDA-approved for contraception since 1992.

Microgestin vs. Depo-Provera Side Effects

Microgestin

Most common
headache (up to 6.3%)
vaginal candidiasis (up to 6.1%)
nausea (up to 4.6%)
menstrual cramps (up to 4.4%)

Depo-Provera

Most common
menstrual irregularities, bleeding/spotting (up to 57%)
weight gain, more than 10 lb (up to 38%)
headache (up to 17%)
abdominal pain/discomfort (up to 11%)

Microgestin vs. Depo-Provera Dosage

Microgestin

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 1 mg/20 mcg once daily Days 1-21
Maximum dose 75 mg ferrous fumarate Days 22-28
Dose changes 2 increases Every 21 days

Depo-Provera

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 150 mg IM injection At the start
Maximum dose 150 mg IM injection Same as starting
Dose changes None Fixed dose

Microgestin vs. Depo-Provera Indications

Microgestin

Microgestin is FDA-approved only to prevent pregnancy in women who choose oral contraception. It does not protect against sexually transmitted infections, including HIV. It combines estrogen and progestin to prevent ovulation.

  • Prevention of pregnancy

  • Does not protect against STIs, including HIV

  • Contains both estrogen and progestin

  • Available in 21-day and 28-day (Fe) formulations

Depo-Provera

Depo-Provera is FDA-approved only to prevent pregnancy. It's not recommended as a long-term method beyond two years unless other options aren't suitable, due to bone density loss risk. It contains progestin only, with no estrogen.

  • Prevention of pregnancy

  • Does not protect against STIs, including HIV

  • Contains progestin only, no estrogen

  • Not recommended long-term (>2 years) without cause

Microgestin vs. Depo-Provera Pros and Cons

Microgestin

Microgestin gives you daily control over your cycle and can be stopped immediately if you want to switch methods or try to conceive. As a combined estrogen-progestin pill, it carries a higher clotting risk than progestin-only options, especially in smokers over 35. It requires remembering a pill every day to stay effective.

Pros

  • Can be stopped immediately, no waiting period

  • Predictable dosing may help regulate cycles

  • No injection needed

  • Available in multiple strengths and pack types

Cons

  • Requires taking a pill every day without missing doses

  • Contraindicated in smokers over 35 due to clot risk

  • Carries estrogen-related risk of blood clots and stroke

  • Effectiveness drops quickly if pills are missed

Depo-Provera

Depo-Provera only needs to be given once every three months, which removes the need to remember a daily pill. As a progestin-only shot, it avoids the estrogen-related clotting risks of combination pills, but it carries a boxed warning for bone density loss with prolonged use. Fertility may take longer to return after stopping the injections.

Pros

  • Only needs to be given once every three months

  • No estrogen, so no estrogen-related clot risk

  • May reduce or stop periods over time

  • No daily pill to remember

Cons

  • Boxed warning for bone density loss with long-term use

  • Irregular bleeding or spotting is common, especially at first

  • Return to fertility can take several months after stopping

  • Weight gain over 10 pounds is common with continued use

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