The Injectable

Contraceptive Injections contain hormones that are used periodically by women to prevent pregnancy. Check Injectable Contraceptive benefits & side effects.

Summary

Yes, it is what you have in mind! A syringe, a needle and some liquid that is injected into your body. The injectable prevents your ovaries from releasing eggs. It also thickens your cervical mucus to help block sperm from getting to the egg in the first place. There are different types –some may not be available in your country.[4]

Monthly injectable: It keeps you protected for a month! Contains two hormones –progestin and estrogen.
NET-EN or two months injectable: It contains progestin. It keeps you protected for two months! A great option for women who can’t take estrogen [5].
DMPA or three months injectable: It contains progestin. It keeps you protected for three months! A great option for women who can’t take estrogen [5].

Quick Facts

Effectiveness: All types of Injectables are very effective –However, you should remember to get the shot on time. When women have injections on time, 99 of every 100 will manage to prevent pregnancy.
Side effects: most common are irregular bleeding and increased appetite, leading to weight gain(typically <2 kg or 4.4 lb). A high number of women using this method will stop having monthly bleeding after the first year of use. Do not worry; this is not harmful!
Effort: low – you need a shot every 1, 2 or 3 months (depending on the types available in your context).
Doesn’t protect against sexually transmitted infections (STIs).

Details

If you do not want to take a pill every day, the Injectable might be a good option. You only need to remember to do something once every 1 (monthly injectable), 2 (NET-EN) or 3 months (DMPA). You will need to see a health provider or trained community health workers to get your injection.
Total privacy. No one can tell when you have used the Injectable. There is no packaging and nothing you need to do before you have sex.
Yes, there are needles involved. If you are scared of needles, then the injectable is not for you. Keep in mind that it is only one shot, and you are done for 1, 2 or 3 months.
Late injection rules. Did you miss the date for your injection? You may still be protected. DMPA injectables (3 months injectables) may be used up to 4 weeks late. NET-EN (2 months injectables) may be used up to 2 weeks late. Monthly injectables may be used up to 1 week late. But, do not make being late the rule! It could reduce the effectiveness of the method. Think about using an alarm on your phone or a paper calendar to keep track of the injection date.
Pregnancy. It is possible to get pregnant as soon as you stop using this method, although for some women it can take several months for fertility to return. If you are not ready to get pregnant get another shot or use a different contraceptive method.

How To Use

You do not need to do much if you choose the injectable, just make sure to get the shot on time with your medical provider.

Have you heard of Sayana Press? It is a self-injection method to prevent pregnancies for 3 months. To learn more about this method, visit injectsayanapress.org.

When you first start using the injectable, discuss your period with the provider or trained community health worker. This will help to decide how soon after the injectable you will be protected.

Tips and tricks

Spotting improves with time. So give it time!
If you start missing your monthly bleeding after one year of using the injection, do not be alarmed! This is normal for users of this method. However, if you have been late with your injections and you suspect you may be pregnant, perform a pregnancy test as soon as possible.
Have you noticed some weight gain with the injection? Do not be alarmed! It is possible to experience weight gain (usually up to 2 kilograms) while using this method. Women who gain weight in the first 6 months of use, may be at higher risk for continued weight gain while using the injection. While some women may not be bothered by this, others will not be happy If you want to keep it off, add some exercise to your daily routine or consult with a provider about your eating habits.

Side Effects

Everyone is different. What you experience may not be the same thing as another person.
The Positive: there are lots of things about using injectables that are good for your body as well as your sex life [3].

Easy to use
Does not interrupt the heat of the moment
Private – no one will know unless you tell them
You do not have to worry about remembering to take it every day
Might give you shorter, lighter periods – or no periods at all
It is very effective at preventing pregnancy – if you get the injectables on time
You can use it while you are breastfeeding (except the monthly injectables)

The Negative: everyone worries about negative side effects, but for many women, they are not a problem. Remember, you are introducing hormones into your body, so it can take a few months to adjust. Give it time.
The most common complaints [6]:

Irregular bleeding, especially for the first 6-12 months (this could mean longer, heavier periods, or spotting in between periods)
Change in appetite or weight gain (It is common for some women to gain 1-2 kg in the first year. Other women gain nothing.)

Less common side effects:

A change in your sex drive
Depression
Hair loss or more hair on your face or body
Nervousness or dizziness
Headache
Nausea
Sore breasts

There is no way to stop the side effects of the injectable. If you feel the side effects are more than you can accept, switch methods and stay protected. Remember, there is a method for everyone, everywhere!
* For a very small number of women, there are risks of serious side effects. Talk to the person who gave you the injectable if you are worried about the side effects that you are experiencing.

References

[1] Dr Marie Marie Stopes International. (2017). Contraception. Retrieved from http://www.mariestopes.org.au/wp-content/uploads/Contraception-brochure-web-200417.pdf

[2] FPA the sexual health charity. (2017). Your guide to contraceptive injections. Retrieved from https://www.fpa.org.uk/sites/default/files/contraceptive-injections-your-guide.pdf

[3] FSRH Faculty of Sexual and Reproductive Healthcare. (Amended 2019). Progestogen-only Injectable Contraception. RCOG. Retrieved from https://www.fsrh.org/standards-and-guidance/documents/cec-ceu-guidance-injectables-dec-2014/

[4] Family Planning Division Ministy of Health and Family Welfare Government of India. (2016). REFERENCE MANUAL FOR INJECTABLE CONTRACEPTIVE (DMPA). New Delhi . Retrieved from https://nhm.gov.in/images/pdf/programmes/family-planing/guidelines/Reference_Manual_Injectable_Contraceptives.pdf

[5] IPPF. (2013). IMAP Brief Statement Comparing Injectable Contraceptives: depot medroxyprogesterone acetate (DMPA) versus norethisterone enanthate (NET-EN). Retrieved from https://www.ippf.org/sites/default/files/tks_medbulletin_july13_en.pdf

[6] Khadilkar, S. S. (2017). Short-Term Use of Injectable Contraception: An Effective Strategy for Safe Motherhood. J Obstet Gynaecol India. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5895545/

[7] Kennedy, et al. (2019). Self-administration of injectable contraception: a systematic review and meta-analysis. BMJ Global Health . Retrieved from https://gh.bmj.com/content/bmjgh/4/2/e001350.full.pdf

[8] PATH. (2016). Depot-medroxyprogesterone acetate (DMPA-SC). Application for Inclusion in the WHO Essential Medicines List. Retrieved from https://www.who.int/selection_medicines/committees/expert/21/applications/s18_medroxyprogesterone_acetate_form.pdf

[9] Rani, S. (2017). A study on injectable DMPA (Depomedroxy progesterone acetale) isomg use as short-term. International Journal of Medical and Health Research. Retrieved from http://www.medicalsciencejournal.com/download/561/3-7-56-875.pdf

[10] World Health Organization Department of Reproductive Health and Research and Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (2018) Family Planning: A Global Handbook for Providers. Baltimore and Geneva. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/260156/9780999203705-eng.pdf?sequence=1

[11] World Health Organization. (2016). Selected practice recommendations for contraceptive use. Geneva. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/252267/9789241565400-eng.pdf?sequence=1