INJECTABLES

INJECTABLE FAMILY PLANNING AND CONTRACEPTIVE METHOD

• As shown by the pictures, injection are given at woman arm, hip or buttock
• They  contain one or two contraceptive hormones ( progestrone or progestrone and oestrogen)
  
• provide protection from pregnancy for one, two, or three months (depending on the type)
•  About 61 percent of all women in Kenya who use modern contraceptive methods choose injectable contraceptives.

There are two types 

• Progestin only Injectable Contraceptives ( POIC) - commony used
• Combined Injectable Contraceptives (CICs) – not commonly used

 

Progestin-Only Injectable Contraceptives (POICs)  

Widely available in two options

• Three month injectable contraceptives (13 weeks) Depo Provera (Depotmedroxyprogesterone acetate-DMPA)
• Two month injectable contraceptives (8 weeks) Noristerat (Norethisterone enanthate-NET-EN). 

 

Combined Injectable Contraceptives (CICs)  

The CICs consist of a natural oestrogen plus a progestogen

Consist of two CIC formulations, both given at four-week (30 days) intervals

• Cyclofem/ Cyclo-Provera,
• Mesigyna/Norigynon,

NOTE:

The guidelines below refer to progestin-only injectables (2 months and 3 months injectable contraceptives)

Advantages of Injectable family planning and Contraceptives in Kenya  

Contraceptive Benefits  

• They are highly effective and safe.
• A pelvic exam is not required to initiate use.
• They contain no oestrogen, so they do not have the cardiac and blood-clotting effects, which are associated with oestrogen containing pills and injectables.
• These are long-acting methods: two or three months, depending on the type.
• Confidentiality

Non-contraceptive Health Benefits

• Absent periods, which might be beneficial for women with (or at risk of) anaemia
• Decrease in sickle cell crises
• Protection against endometrial cancer
• Protection against uterine fibroids
• Possible protection from symptomatic pelvic inflammatory disease
• Possible prevention of ectopic pregnancy

  Side Effects and Limitations of Injectable Contraceptives  

• Return of fertility may be delayed for about four months or longer after discontinuation.
• They offer no protection against STIs, including hepatitis B and HIV;
• This method is provider-based, so a woman must go to a health
• Care facility regularly.
• Use of injectables could be associated with the following side minor effects: 

– Menstrual changes, such as:

- Irregular bleeding

- Heavy and prolonged bleeding

- Light spotting or bleeding

- Absent periods, especially after one year of use

– Weight gain

– Headache

– Dizziness

– Mood swings

– Abdominal bloating

– Decrease in sex drive

Women Who Can Use Injectables Planning and Contraceptives in Kenya without Restrictions  

Both two months and three months injectable contraceptives are acceptable for all women between the ages of 18-45 with established menses who fall into his category

• Women who had children or have never given birth
• Women who want highly effective, long-term protection against pregnancy
• Mothers who are breastfeeding (after four weeks postpartum)
• Mothers who are not breastfeeding (immediate postpartum)
• Women with fibroids, endometrial cancer, or benign breast disease
• Women who cannot remember to take the pill everyday
• Post-abortion clients
• Women with anaemia, sickle cell disease, and thyroid disease
• Women with STIs and PID
• Women with viral hepatitis (acute/fl are, carrier, or chronic) and those with mild (compensated) cirrhosis.
• Women with obesity (i.e., BMI greater than 30 kg/m2
• Women receiving anticonvulsants (e.g., phenytoin, carbamazepine, barbiturates, primidone, topiramate, oxcarbazepine, or lamotrigine)

Women Who Can Use Progestin-Only Injectables Family Planning and Contraceptives in Kenya, with Extra Precautions 

 This catergory should seek medical consultation

• Women who are younger than 18 or older than 45.
• Decreased bone density
• Heavy or irregular vaginal bleeding patterns.
• Cervical cancer awaiting treatment
• Migraine without aura.
• From major surgery with prolonged bed hospitalization
• Women on anticonvulsants such as phenytoin, carbamazepine, barbiturates, primidone, topiramate, and oxcarbazepine.
• Gall bladder disease, symptomatic or asymptomatic.
• Uncomplicated diabetes.

Women Who Should Not Use Progestin-only Injectable   Family Planning and Contraceptives in Kenya

• Breastfeeding women less than four weeks birth
• Women with severe liver cirrhosis
• Women with benign (Hepatocellular adenoma) or malignant liver tumour (hepatoma)
• Women with unexplained abnormal vaginal bleeding
• Women with multiple risk factors for arterial cardiovascular disease (various combinations of older
• Age, smoking, diabetes, and hypertension
• Women with a current case of or history of ischaemic heart disease
• Women with diabetes mellitus complicated by vascular disease
• Men whose blood pressure is equal to or higher than 160/100, and women with vascular disease
• Women with a current diagnosis or history of breast cancer

When to Start Using Injectable Family Planning and Contraceptives in Kenya  

A woman can start injectables at any time if it is reasonably certain she is not pregnant.

If she starts using an injectable within seven days after the start of her monthly bleeding, she will not need a back-up method.

If she starts using an injectable more than seven days after her monthly bleeding, she should use a backup method for the first seven days after injection.

Obtaining This Method

Level 4 and above (hospitals)

Level 3 (health centers, nursing and maternity homes)

Level 2 (dispensaries, HTC centers, private clinics)

Level 1 (outreach, including CHWs and mobile services), and home-based care (provided by a nurse or midwife)

Injectable contraceptives can be obtained from the following clinical providers:

Medical doctors

Clinical officers

Nurses and midwives

END INJECTABLE CONTRACEPTIVES .ANY QUESTION? ASK HERE. RESPONSE IN ATLEAST 4 HOURS TO YOUR MAIL

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