Progestogen-only injectable contraceptive
Progestogen-only injectable contraceptives are a form of birth control that involve the administration of synthetic progestogen hormones to prevent pregnancy. These contraceptives work primarily by inhibiting ovulation, thickening the cervical mucus to prevent sperm from reaching an egg, and thinning the endometrium to prevent implantation of a fertilized egg. They are a type of long-acting reversible contraception (LARC), offering an effective and reversible means of birth control for an extended period without requiring daily attention.
Types of Progestogen-only Injectable Contraceptives
There are two main types of progestogen-only injectable contraceptives, which differ based on the duration of their effectiveness and the type of progestogen used:
- Depot medroxyprogesterone acetate (DMPA), which is available in two forms:
- Intramuscular DMPA (Depo-Provera), which is injected into a muscle and provides protection against pregnancy for three months.
- Subcutaneous DMPA (Sayana Press), which is injected under the skin and also offers three months of contraceptive protection.
- Norethisterone enanthate (NET-EN), which is injected into a muscle and provides contraceptive protection for two months.
Mechanism of Action
The primary mechanism by which progestogen-only injectable contraceptives prevent pregnancy is by suppressing ovulation, ensuring that no egg is released for fertilization. Additionally, these contraceptives increase the thickness of the cervical mucus, making it difficult for sperm to navigate through the cervix and fertilize an egg. They also alter the lining of the uterus (endometrium), making it less suitable for implantation.
Advantages
Progestogen-only injectable contraceptives offer several advantages, including:
- High efficacy in preventing pregnancy when used correctly and consistently.
- Long-term protection, with injections required only every two to three months.
- A convenient contraceptive option for those who prefer not to take a daily pill.
- Suitable for use by women who cannot use estrogen-containing contraceptives, such as those with certain health conditions or breastfeeding mothers.
Disadvantages
Despite their benefits, progestogen-only injectable contraceptives also have some disadvantages:
- They do not provide protection against sexually transmitted infections (STIs).
- Possible side effects, such as changes in menstrual bleeding patterns, weight gain, and mood changes.
- A delay in the return to fertility after stopping the injections.
- The need to visit a healthcare provider for each injection.
Considerations
Before choosing a progestogen-only injectable contraceptive, individuals should consider their overall health, reproductive goals, and potential side effects. It is important to discuss with a healthcare provider to ensure that this form of contraception is appropriate for their specific needs.
Conclusion
Progestogen-only injectable contraceptives are a highly effective and convenient form of birth control for many women. However, the choice of contraceptive method should be based on a thorough understanding of the benefits and potential drawbacks, in consultation with a healthcare provider.
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Contributors: Prab R. Tumpati, MD