Injectable Contraception: Current Practices and Future Trends

Abstract

Injectable contraception includes progestin-only and combined estrogen and progestin agents that provide safe and highly effective birth control for one to three months. Injectable agents are widely available and play an important role in family planning programs worldwide. Depot medroxyprogesterone acetate, available for intramuscular injection and subcutaneous injection, is the best known and most broadly distributed injectable contraceptive agent, and is an ideal agent for women who have contraindications to estrogen use. Despite their effectiveness, progestin-only injectables are associated with high rates of discontinuation due to bothersome side effects including abnormal bleeding, health controversies including decreased bone mineral density, and increased risk of human immunodeficiency virus acquisition. Injectables do offer non-contraceptive benefits including symptom control related to endometriosis and fibroids, and decreased risk of endometrial cancer. Research is ongoing to determine new injectable hormone formulations that provide longer-acting contraceptive protection and fewer side effects.