Purpose As breast cancer survival rates improve, the quality of survivorship becomes more important. Historically there has been less overlap between age groups with the highest incidence of breast cancer and younger populations using progestins for contraception and period management. However, with trends towards younger age at diagnosis and improvements in treatments contributing to preserved fertility and ovulation in survivors, the safety of progestins must be re-examined. Methodology A two-armed systematic review was undertaken for (1) depot progestin injection and (2) progestin-releasing IUD in breast cancer survivorship. This resulted in 11 papers for (1) and 20 papers for (2). Results The volume of research in this area is very small. The published literature predominantly arises from North American and large Scandinavian database research. Although data is often collected prospectively, it is not collected with a primary focus on progestins and the analyses are always retrospective. However, despite limited data and the quality limitations described, depot progestins are not associated with an increase in breast cancer incidence or recurrence except in specific subgroups such as women under 35 years, and women with recent use of progestin within 5 years. For progestin-releasing IUDs, there is a small increase in breast cancer incidence de novo, but insufficient evidence to make conclusions regarding safety in breast cancer survivors. Conclusion The safety of progestins in breast cancer survivors is an area that is under-studied despite being likely to assume greater importance with changes in epidemiology and treatment. Available evidence suggests that depot progestins may be safe except in specified subgroups while progestin-releasing IUDs are associated with an increased risk in de-novo incidence. This is at odds with their mechanisms of action (depot acting systemically and IUD acting locally) and deserves much more research.