Injectables



 

There are two types of injectable contraceptives. One is effective for two months and the other for three months. Injectable contraceptives contain synthetic hormone called progestin, similar to the hormone progesterone produced in the woman's body. After being injected into the muscle, the progestin is slowly released. Injectable contraceptives act in three ways to prevent pregnancy:

         They cause cervical mucus to become too thick for sperm to pass through;

         They suppress ovulation; and

         They cause the lining of the uterus to become less rich in blood vessel and unprepared for an egg to implant.

Benefits

         Very effective (Efficacy is 99.6%);

         Long acting;

         Effective even if the client is a week late for her return visit;

         Offer privacy to user;

         May help decrease anemia;

         Appealing to those whole shots better than pills;

         Do not significantly affect breast milk supply or quality;

         Nothing to remember beyond returning for follow up visit;

         Does not interfere with sexual intercourse;

         Useful for women who want no more children, but prefer not to have sterilization;

         Useful for women over 35 years of age;

         Provides some protection against pelvic inflammatory disease; and

         Do not have the serious heart and blood clotting effects.

Limitations

         Do not protect against STDs;

         Since they are long acting, cannot be easily discontinued or removed from the body; and

         The injectable contraceptive for three months may worsen diabetes but the one that is for two months has no effect on glucose tolerance and hence is the better option for women with diabetes;

Indications

         Injectable may be an appropriate method for a woman who:

         Prefers a contraceptive which does not require action either before intercourse or every day;

         Is breast feeding and needs and wants a contraceptive;

         Already has two or more children, but does not want a permanent method;

         Has had estrogen related side effects from combined oral contraceptive including vascular headaches (migraine), nausea, high blood pressure or breast tenderness; and

         Has sickle cell disease.

Contraindications

If the following signs appear, this should be taken as an emergency situation and the woman taking oral contraceptives should be taken to a hospital immediately.

         Pregnancy;

         Unexplained vaginal bleeding;

         Jaundice;

         Breast cancer;

         Epilepsy;

         Tuberculosis;

         Women who cannot remember to take pills every day;

         Uncontrolled Diabetes Mellitus

         Hypertension of 160/100 or more;

         Severe headaches; and

         Depression;

Sides effects & management

Amenorrhea

Check for pregnancy. If ruled out, continue with injectable;

Bleeding / Spotting

Examine for genital tract lesions such as vaginitis, cervicitis, cervical polyps or uterine fibroids.
Continue and if you are not satisfied, two treatment options are recommended:

  • Take a cycle of COCs; or
  • Ibuprofen up to 800mg 3 times daily for five days;

Amenorrhea

Evaluate Genital Tract abnormality, if not found supplement with

  • a cycle of COCs; or
  • Ibuprofen up to 800mg 3 times daily for five days;

Danger sign

                If the following signs appear, this should be taken as an emergency situation and the woman taking injectable contraceptives should be taken to a hospital immediately.

         Severe lower abdominal pain

         Severe headache

         Loss of or blurred vision

         Heavy or prolonged vaginal bleeding;

Where to get services

The services are available in all program and non program outlets.

 

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