Hormonal contraceptives—progestogen injections

General information

For a complete account of adverse reactions to progestogens, readers should consult the following monographs as well as this one:

• Hormonal contraceptives—intracervical and intravaginal

• Hormonal contraceptives—oral

• Hormonal contraceptives—progesterone implants

• Hormone replacement therapy—estrogens + progestogens

• Medroxyprogesterone

• Progestogens.

Injectable hormonal contraceptives, which are normally composed of long-acting esters of progestogens, have obvious practical advantages over oral products when user adherence is poor, for example in illiterate or mentally subnormal women or in some populations in developing countries. However, the fact that they are used in this type of patient has led to some social protest against their use, as if they were intended to undermine free will or provide cheap but unpleasant contraception for the underprivileged. This may in turn explain some unbalanced criticism of these products in terms of efficacy and safety. Their sometimes incomplete cycle control is indeed a practical disadvantage, but not a risk, and the fact that they contain no estrogen actually means that they are safer in those respects when risks of hormonal contraception are due mainly to estrogenic effects, particularly thromboembolic complications. All in all, the injectable hormonal contraceptives provide effective, reversible, and relatively safe contraception, which can well be used not only in the populations named above but also, for example, in some women who smoke or when an estrogen is contraindicated [ , ].