Progestin-only injectable contraceptives (e.g., Depo Provera, Noristerat) contain no estrogen. To prevent pregnancy, a shot is given every two or three months, depending on the type of injectable.
How do they work? (mechanism of action)
Prevent ovulation
Thicken cervical mucus (make it hard for sperm to penetrate)
Change endometrium (make it thin and probably not suitable for implantation)
Who can use progestin-only injectables?
Women of any reproductive age or parity who:
Want to use this method of contraception
Have no contraindications
Who should not use progestin-only injectables?
Women who have the following conditions (contraindications):
Pregnancy
Unexplained vaginal bleeding (before evaluation)
Current breast cancer
(For more information, see WHO eligibility criteria.)
Advantages
Highly effective
Reversible (with delay in return to fertility)
Easy to use
Do not interfere with intercourse
Private
Do not affect breastfeeding
Have beneficial non-contraceptive effects (protection from endometrial cancer, ectopic pregnancy and symptomatic PID). May reduce sickle crises in women with sickle cell anemia
May prevent seizures in epileptics
Disadvantages
Delay return to fertility (by average of nine months after the last injection)
Have common side effects
No protection from STIs/HIV
Possible side effects
Irregular menstrual bleeding/spotting
Amenorrhea
Weight gain
Headaches
Nausea
Provide follow-up and counseling for:
Any client concerns
Common side effects, especially irregular bleeding/spotting or amenorrhea
