Currently there are two main types of injectables available only by Rx, which are progestin-only injectables and monthly combined injectables. Lets get into it!
Active Ingredients: contains either progestin hormone depot medroxyprogesterone acetate (DMPA) or norethisteron enanthate (NET-EN)
Action: Injected intramuscularly or in some cases, subcutaneously with newer forms of DMPA. These injectables work by preventing the release of eggs from the ovaries, thereby hindering ovulation
Effectiveness: Highly user dependent, meaning how regularly you stick to your injection schedule will change the effectiveness against pregnancies. Within the first year of use, 4/100 woman will become pregnant when using progestin-only injectables. When taking injectables on time, this risk decreases to less than 1/100
Fertility: After taking progestin-only injectables, the return of fertility is often delayed months longer than other forms of hormonal contraceptives. Return of fertility under DMPA is 4 months longer and 1 month longer under NET-EN comparatively
Protection against STIs: None
Benefits: Since injectables are long acting, women only need to administer every 2-3 months, curbing the need for daily pill-taking. This does not interfere with sex and is often more private for woman who don't want others to know her personal contraceptive use. Additionally, as a progestin-only contraceptive, these injectables can be taken by breastfeeding mothers as soon as 6 weeks after birth
Side effects: Common experiences among women include 1-2kg weigh gain, headaches, dizziness, abdominal discomfort and mood swings. With DMPA, women will experience irregular or prolonged bleeding and after the 1st year, bleeding often stops completely or is less frequent. With NET-EN, bleeding patterns are less affected as bleeding becomes lighter in the first 6 months and after a year, bleeding is more likely to reoccur compared to DMPA
Active ingredients: combined hormonal ingredients with a progestin and an estrogen. Common combinations include medroxyprogesteron acetate (MPA)/estradiol cypionate and norethisterone enanthate (NET-EN)/estradiol valerate. Older formulations exist but are less common.
Action: Injected intramuscularly and work by preventing the release of eggs from the ovaries, thereby hindering ovulation
Effectiveness: Similarly, highly user dependent, as compliance increases effectiveness. Within the first year of use, 3/100 woman become pregnant and this decreases to less than 1 pregnancy per 100 with injections taken on time
Fertility: After taking CICs, the return of fertility is often delayed 5 months longer than other forms of hormonal contraceptives
Protection against STIs: None
Benefits: These injectables are similarly long acting, women only need to administer every month, curbing the need for daily pill-taking. This does not interfere with sex and is often more private for woman who don't want others to know her personal contraceptive use. Users of CICs also benefit from the ability to space births, easier and more controlled than progestin-only injectables
Side effects: Common experiences among women include weight gain, headaches, dizziness, and breast tenderness. When it comes to bleeding, it often it is lighter and less frequent. This could lead to some period of irregular bleeding or long-term lack of bleeding.
Making the decision can be challenging, however, the main points are sensitivity to active ingredients, status of breastfeeding, effectiveness and desire to become pregnant in the future. Weighing these options are essential to determining whats best for you, and your plans for the future. Let us know which one you chose and how its going for you in the comments below!
(1) Huff, M. B. (2009). Family Planning: A Global Handbook for Providers. Journal of Pediatric and Adolescent Gynecology, 22(2), 135–135. Link.
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