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Abstract

Injectable contraceptives are a valid option in every family planning program. Contraceptives which are administered every 2 or 3 months, containing only progestogen agents (DepoProvera, Noristerat) have proven efficacious and do not show long-term safety problems. They differ from other contraceptives in their long lasting action and by not presenting the contraindications of the estrogens. Their most prominent side-effect is the irregularity of cyclic bleeding. Although bleeding irregularities are not life threatening, many users stop the treatment for that reason. Monthly contraceptives comprising progestogens and estrogens, maintain or improve the high efficacy of the earlier forms and have the added benefit of allowing bleeding to resemble the physiologic one. This increases acceptability and the continuation rate. There is no long-term inconvenience. At this point, the greatest experience is with the formulation known as Topasel or Perlutal. Other formulations (Cyclofem, Mesigyna) are beginning to be commercialized and their characteristics must still be confirmed through daily use. Indications, contraindications, precautions and warnings for the use of monthly injectable contraceptives are basically identical to those of the combined oral contraceptives, as are the side-effects. Efficacy, though, proves to be superior, which can be correlated to a simpler method of use and less risk of error when using it. Main motivation factors are: efficacy, simplicity in usage, reversibility and confidentiality.

Cut-off levels for hyperandrogenemia among Samoan women: An improved methodology for deriving normative data in an obese population

“…This allowed us to exclude women who may have been using contraceptive injections. Contraceptive injections can result in irregular menstruation and altered androgen levels [12, 14]. We are thus able to better understand the relationship between adiposity and androgens and accordingly establish normative androgen data quantitatively taking into consideration BMI.…”

“…Women who did not report their menstrual cycle data (n=10), or lacked anthropometric measurements (n=1) or fasting serum samples (n=49) were also excluded. Because using exogenous hormone injections for contraception can result in irregular menstruation and altered androgen levels [14], we excluded women who indicated ever using contraceptive injections (n=173). The final study sample size for this analysis was n=494.…”

Reproductive health, obesity, and cardiometabolic risk factors among Samoan women

“…Women who did not report their menstrual cycle data (n = 10) or who lacked anthropometric measurements (n = 1) or fasting serum samples (n = 49) were also excluded. Because using exogenous hormone injections for contraception can result in irregular menstruation and altered androgen levels (De Aguilar et al 1997), we also excluded women who indicated ever using contraceptive injections (n = 173). Women responding “within the last 12 months” rather than choosing more specific responses of time frame for their last menstrual cycle were excluded due to ambiguity of the response (n=24).…”

“…However, we did not have data on contraceptive injections, which previous studies have found are the most commonly used contraception by Samoan women (Brewis et al 1998). Contraceptive injections can both stop menstrual cycles and alter serum androgen levels, masking the true prevalence of menstrual irregularity and hyperandrogenemia (de Aguilar et al 1997). …”