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

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by Maddie Braidwood · Sep 30, 2020

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Reviewed by Dr. Melanie Davis-Hall on 1 April, 2021

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Depo -Provera, Sayana Press and Noristerat are similar in many ways, but what are the differences between these threetypes of contraceptive injection?

The contraceptive injection is a popular contraceptive, and because of its longevity and practicality, it is a firm favourite amongst many women. So which is the best?

There are three different types of injection, Depo-Provera and Sayana Press and Noristerat. Each have very similar side effects and method of action, however, differ when it comes to how they are administered. This post will explain everything you need to know.

So first up… what’s the difference between Sayana Press, Depo-Provera and Noristerat?

Both Depo-Provera and Sayana Press are a brand name for medroxyprogesterone acetate (DMPA). This is a contraceptive injection that contains the hormone progestin, a synthetic form of the natural hormone progesterone. This works by suppressing ovulation and keeping your ovaries from releasing an egg, 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.

Noristerat is very slightly different. It is a progestogen-only injectable contraceptive which is commonly used in Europe, Africa and Southern America. It is not commonly prescribed in the UK or USA at present.  It contains a different type of progestogen to Sayana Press and Depo-Provera called norethisterone enantate and lasts for 8 weeks, after which it must be injected again to be effective.

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 the percentage decreases if you do not receive the injection at the right time.

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

Depo-Provera and Noristerat must be injected by a health care 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.

You can now order Sayana Press directly from The Lowdown! Learn how to inject the Sayana press contraceptive injection here 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 years 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, all you need to do is not have your next injection – 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. 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 this blog about a user’s experience of coming off the injection with some insights from our resident GP Dr Mel.

You can also check out our survey results to see how long it took most women’s cycles to return to their definition of ‘normal’ after their injection, and learn about effects they’ve experienced.

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 Lowdown users was 62% of Sayana Press users said it stopped there periods, compared to 71% of Depo-Provera. We currently don’t have enough data for Noristerat to compare. Please 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. Women 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 this contraceptive injection include:

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

Though 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 precedes migraine pain

What do our users say?

Below is a selection of our real-life user reviews for each brand of contraceptive injection…

Depo Provera

“Best contraception I have ever been on, I’ve struggled to find one that agreed with me as much as this, but it can only be used for up to 3 years as it has increased risk of osteoporosis and breast cancer after that. I lost weight, felt very stable and my mood wasn’t impacted. Yes, there were ‘fuzzy’ days where you felt moody and knew yourself you were being a bit overly sensitive to things, but that came and went like PMS. No periods for 3 years and my sex drive and skin was great.”

“I had two injections of depo. I had spotting daily for the entire time I was on it. I gained weight, was very depressed, and lost libido. It was my worst experience.”

Read more Depo Provera reviews

Sayana Press

“Easiest contraception I’ve ever had! No issues apart from possibly more spots however that could be linked to a change in lifestyle that occurred at the same time.”

“Good alternative to Depo as you can administer at home, I have found that it has a few more side effects to it than Depo but they’re manageable.”

Read more Sayana Press reviews

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.

Which injection is best for me?

As we always say at The Lowdown, everyone is different will experience different side effects and benefits from different methods. 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 want to compare the injection against other methods of contraception, check out our brand new Contraception Comparison Tool. Here you can compare any brand or type of birth control – just like the latest iPhone model. Pop in Noristerat vs Depo Provera and compare side effects, ratings and risks to your heart’s content.

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Maddie is an English Language and Linguistics graduate who is passionate about writing. She writes fun and informative content on the weird and wonderful sides of contraception!