What is the Contraceptive Injection?
The contraceptive injection is a long-acting hormonal birth control method administered via an intramuscular (IM) injection. It contains 150 mg of depot medroxyprogesterone acetate (DMPA), a synthetic form of the hormone progestin. DMPA works by gradually releasing progestin into the bloodstream, preventing ovulation and thickening cervical mucus to block sperm entry. This method is highly effective, with a real-world efficacy rate of approximately 94%. For optimal effectiveness, additional contraception, such as condoms, is recommended for the first week after the initial injection.
How Does the Contraceptive Injection Work?
DMPA provides contraception for up to 3 months with a single injection. Its primary mechanisms include:
- Inhibition of Ovulation: Prevents the release of eggs from the ovaries.
- Thickening of Cervical Mucus: Prevents sperm from entering the uterus.
- Thinning of Uterine Lining: Makes it less likely for a fertilized egg to implant.
These combined effects result in a contraceptive efficacy rate of 99.6%.
Advantages and Disadvantages
Advantages:
- Does not affect sexual desire or performance.
- Safe for breastfeeding mothers without impacting milk production.
- Reversible; fertility typically returns within 2 to 4 months after discontinuation.
- Suitable for women who prefer a non-daily contraceptive method
- Does not increase the risk of cardiovascular diseases or hypertension.
Disadvantages:
- May cause menstrual irregularities, including spotting or heavier periods, which usually improve after 3–6 months.
- Potential side effects include headaches, dizziness, nausea, fatigue, and breast tenderness.
- Bone density loss may occur with prolonged use (2 years or more).
- Possible weight gain, with some users experiencing increases up to 10 kg within 3 months.
- Does not protect against sexually transmitted infections (STIs); condoms should be used to prevent STI transmission.
Contraindications
DMPA should not be used in individuals with:
- Severe liver or kidney disease.
- History of breast cancer, even if previously treated.
- Unexplained vaginal bleeding.
Current use of certain medications, such as those for tuberculosis or epilepsy.
Administration and Follow-Up
The first DMPA injection is typically given within 5 days of the onset of menstruation. Subsequent injections are administered every 3 months, with a 2–4 week grace period. If an injection is delayed beyond 4 weeks, additional contraceptive methods should be used for the first 7 days after administration.
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