 Very
effective against pregnancy
- Non-contraceptive health benefits
- No daily action required or supplies
needed at home
- Use independent of sexual intercourse and
can be used without partner knowledge
- Require clinic visit
- No STI protection
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Young adults can safely use injectables and implants, which
are hormonal contraceptives. There are two main progestin-only
injectables. Depo-Provera, or DMPA (depot-medroxyprogesterone
acetate), is given every three months, and NET-EN, or Noristerat
(norethisterone enanthate), is given every two months. Combined
estrogen-progestin injectables, which include Cyclofem and Mesigyna,
must be taken monthly and are not yet widely available.
The most common implant, Norplant, contains six thin, flexible,
rod-like capsules containing the progestin levonorgestrel. Inserted
under the skin in a woman's arm in a simple surgical procedure,
it is effective for up to five years. Norplant II, or Jadelle,
which consists of two rods that release levonorgestrel, is effective
for at least three years. Implanon, consisting of one capsule
that releases the progestin 3-ketodesogestrel, is also recommended
for three years of use.
Both injectables and implants are very effective, with pregnancy
rates of less than 1 percent after one year of use. Like oral
contraceptives, they have long-term, non-contraceptive benefits.
These include decreased risk of pelvic inflammatory disease,
ectopic pregnancy and endometrial cancer. Injectables and implants
do not require daily action, and no supplies are needed at home.
Their use is independent of sexual intercourse, and they can
be used without partner knowledge.
Injectables require a periodic trip to a provider. For implants,
the clinic visit for insertion or the high initial cost may
be a barrier for many youth.
Like the pill, injectables and implants do not protect against
STIs. A theoretical concern exists regarding use of implants
and progestin-only injectables by women under age 16. Using
these methods reduces a woman's level of estrogen and may have
an impact on developing bone mass, which could potentially predispose
young women to osteoporosis in later life. However, definitive
studies on this question have not been completed.
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