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

There are three different types of contracetive injection, Depo-Provera,  Sayana Press and Noristerat. The injection is a firm favourite amongst many of our reviewers because of its longevity and practicality. Each have very similar side effects and method of action, however, differ when it comes to how they are administered.

What’s the difference between Sayana Press and Depo-Provera?

Both Depo-Provera and Sayana Press are brand names for medroxyprogesterone acetate (DMPA). This is a contraceptive injection that contains the hormone progestin, a synthetic form of the natural hormone progesterone. It works by suppressing ovulation and keeping your ovaries from releasing an egg each month, as well as thickening cervical mucus to keep sperm from reaching the egg.

Both are a highly effective method of preventing pregnancy and must be injected every 13 weeks.

How is Noristerat different to Sayana Press and Depo-Provera?

Noristerat is slightly different. It’s also a progestogen-only injectable contraceptive, but it contains a different type of progestogen to the Sayana Press and Depo-Provera called norethisterone enantate. Noristerat lasts for 8 weeks, after which it must be injected again to be effective. It’s more commonly prescribed in Europe, Africa and Southern America, and much less commonly prescribed in the UK or USA at this time.

Noristerat is also known as Doryxas, Norethisterone injectable, Norigest, Nur-Isterate, Syngestal, and Unidepo.

How effective is the contraceptive injection?

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

How do I switch between brands of contraceptive injection?

Changing from Sayana Press to Depo-Provera (or vice versa) is relatively easy as they are both the same progestogen-only injectable brands. The important thing is to ensure there is no risk of pregnancy. Make sure you get you new injection when your next one would have been due; don’t delay or wait for it to wear off. Our medical team have put together a handy guide on switching your contraceptive safely, so you don’t have to do the mental maths to work out if you’re fully protected – we’ve done the work for you!

Which injection is best for me?

As we always say at The Lowdown: everyone is different, meaning the side effects and benefits you experience could vary between methods, as well as differ from other people’s experiences.

Sayana Press is a lower dose version of Depo-Provera, but there is little evidence of there being dramatic differences in the side effects. The best thing about Sayana Press is that you can inject it yourself at home, so you can avoid clinic appointments and needing a healthcare professional to give you your injection.

If you have decided that you want to try the Sayana Press, once you’ve been shown how to administer it yourself by a healthcare professional, you can order Sayana Press straight from The Lowdown to save the faff of going to a physical appointment! What’s more, we also offer a subscription service, so you never have to worry about running out or remembering to reorder.

Sayana Press vs Depo-Provera vs Noristerat: side effects

All contraceptive injections have very similar side effects. These 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 the Lowdown community (at the time of reviewing) is stopped periods, reported by 65% of Sayana Press users and 70% of Depo-Provera users – the highest of all contraceptives on The Lowdown! We currently don’t have enough data for Noristerat to compare, so lease leave a review and share your experiences with us.

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

Less common side effects of the contraceptive injection include:

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

Although 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 often precedes a headache

You can also compare the different brands of injection side by side, and against other methods of contraception, using The Lowdown’s contraception comparison tool, including ingredients, more reported side effects and other benefits.

What do our reviews say?

Below is a selection of real-life user reviews by The Lowdown community for each brand of contraceptive injection

Depo-Provera reviews

Check out more Depo Provera reviews here!

Sayana Press reviews

Check out more Sayana Press reviews here!

How do I switch between brands of contraceptive injection?

Changing from Sayana Press to Depo-Provera (or vice versa) is relatively easy as they are both the same progestogen-only injectable brands. The important thing is to ensure there is no risk of pregnancy. Make sure you get you new injection when your next one would have been due; don’t delay or wait for it to wear off. Our medical team have put together a handy guide on switching your contraceptive safely, so you don’t have to do the mental maths to work out if you’re fully protected – we’ve done the work for you!

Which injection is best for me?

As we always say at The Lowdown: everyone is different, meaning the side effects and benefits you experience could vary between methods, as well as differ from other people’s experiences.

Sayana Press is a lower dose version of Depo-Provera, but there is little evidence of there being dramatic differences in the side effects. The best thing about Sayana Press is that you can inject it yourself at home, so you can avoid clinic appointments and needing a healthcare professional to give you your injection.

If you have decided that you want to try the Sayana Press, once you’ve been shown how to administer it yourself by a healthcare professional, you can order Sayana Press straight from The Lowdown to save the faff of going to a physical appointment! What’s more, we also offer a subscription service, so you never have to worry about running out or remembering to reorder.

How do I use Depo-Provera, Sayana Press and Noristerat?

Depo-Provera and Noristerat must be injected by a healthcare 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 – it 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 now possible for you to inject Sayana Press yourself at home, making it a much more accessible method!

Still learning how to inject the Sayana Press? Check out our instructions for how to inject the Sayana press contraceptive injection with our very own Dr Becky.

After the injection has been given or administered at home, 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 year 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 the contraceptive injection?

To stop using the injection, all you need to do is not have your next dose – 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 once you stop using it. 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 our blog by one Lowdown reviewer, who shares her experience about coming off the injection with some insights from our resident GP, Dr Mel.

You can also check out our injection side effects results to see how long it took most Lowdown reviewer’s cycles to return to their definition of ‘normal’ after their injection.