Contraceptive injection experiences turn on two things you should know beforehand. Your period almost always changes, and in many women it disappears entirely after a year. And you cannot undo the injection: it wears off at its own pace, and that takes longer than most people expect.
That second point is the most underplayed thing in nearly everything written about the injection. A pill you can simply leave in the packet tonight. An injection is in you for three months, and keeps working after that.
How does the contraceptive injection work?
The injection contains medroxyprogesterone acetate, a progestogen, given by your GP or practice nurse every 12 to 13 weeks. It switches off ovulation and thickens cervical mucus so sperm cannot pass. It contains no oestrogen. Given correctly and on time, reliability is very high according to Thuisarts.nl.
The injection usually goes into your upper arm or buttock. From then until your next appointment there is nothing to remember, and for many women that is precisely the appeal.
The drug is released slowly from a depot in your muscle or subcutaneous fat. That slow release explains both the convenience and the biggest drawback.
Do you still get periods on the injection?
Usually not, in time. In the first months irregular bleeding or spotting is very common, sometimes for weeks on end. The longer you use it the more that settles, and after roughly a year a large share of users have no period at all. With this method that is not a fault but the expected course.
| Period | What women commonly report |
|---|---|
| Injection 1, weeks 1 to 12 | Irregular bleeding or prolonged spotting |
| Injections 2 and 3 | Bleeding becomes shorter and lighter |
| After about 1 year | In many women periods stop altogether |
| After the last injection | Bleeding pattern returns, often only after months |
| Return of fertility | Median around half a year, sometimes longer |
No period here does not mean something is building up or going wrong. Your womb lining is kept thin, so there is simply little to shed. If bleeding instead continues for months, discuss that with your GP.
What are the drawbacks of the injection?
The biggest drawback is that you cannot stop it. If the side effects bother you, you have to sit them out until the injection wears off, and that runs at least to the end of the twelve weeks. With a pill or ring you switch within a day.
Beyond that, women report weight gain, headache, tender breasts and a flatter mood. Of those, weight is the most studied and also the most disputed.
The injection is also linked to a fall in bone mineral density during use. A review from 1999 brought bone density, weight and mood together for long-acting hormonal contraception. The bone effect appears largely to recover after stopping. Even so, it is why your doctor pays extra attention if you are young or have other risk factors. There is more in our article on bone loss.
How long until the injection wears off?
Longer than twelve weeks. Protection continues well past the last injection, and ovulation returns gradually afterwards. Research into return of fertility after injectable contraception describes a median delay of roughly half a year from the final injection, with wide variation between women.
One thing matters here: that delay does not depend on how long you used the injection. Someone who had two can wait as long as someone who had ten.
Picture two women who both have their last injection on 1 March. One has a period again by September and conceives that same year. The other waits until the following summer, eleven months later. Same drug, same 150 milligram dose, a completely different timeline.
If you want to conceive within a year, that is a reason to look at another method with your GP. A copper IUD and the mini pill are both reversible almost immediately.
What does the injection cost?
The injection itself is relatively cheap in the Netherlands; you pay per ampoule and it lasts three months. Contraception is reimbursed from basic insurance up to age 21. Older than that and it usually falls to your own costs or supplementary insurance.
Add the time for four appointments a year. For some women that is the real objection: four visits while an IUD lasts years.
Testing your hormones after the injection
If your period stays away for a long time after stopping, blood testing can help your GP tell things apart. Values often looked at are oestradiol, FSH, LH, prolactin and your thyroid. A low oestradiol fits an ovulation that has not restarted, though that needs interpreting in context.
The oestradiol test from Lunara measures that value, with an assessment by a BIG-registered doctor. It gives a starting point for the conversation, not a diagnosis.
What an absent period can otherwise mean is covered in irregular periods and in our overview of birth control and your hormones.
Frequently asked questions
Is the injection better than the pill?
Better depends on what you want. The injection asks for four moments a year instead of daily recall, which makes it more reliable in practice for anyone who forgets pills. The price is that you cannot reverse it.
Can you give the injection yourself?
A subcutaneous version exists that can be given at home after instruction. Whether that suits you is for your GP to decide.
Does the injection make you gain weight?
Weight gain is reported more often with this method than with other hormonal contraception. How large the average effect is remains inconsistent across studies.
What do you notice when you stop?
Often nothing at first, because the drug is still working. Your bleeding pattern then returns gradually, usually within six to twelve months.
The injection suits women who want no daily task and no pregnancy in the next few years. If you are unsure about that second part, discuss a method you could stop tomorrow instead. That conversation goes better before the first injection than after it.
Every blood test result includes a professional assessment from a BIG-registered doctor. For treatment decisions, discuss your results with your GP.
References
- Thuisarts.nl. Using the contraceptive injection. Accessed 2026.
- NHG Guideline on Contraception. Dutch College of General Practitioners. Accessed 2026.
- Fotherby K, Howard G. Return of fertility in women discontinuing injectable contraceptives. Journal of Obstetrics and Gynaecology, 1986. PMID 12315276.
- Kaunitz AM. Long-acting hormonal contraception: assessing impact on bone density, weight, and mood. International Journal of Fertility and Womens Medicine, 1999. PMID 10338269.
الكاتب
