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Updated: May 11, 2026

Microinjectrode System for Combined Drug Infusion and Electrophysiology
08:30

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Published on: November 13, 2019

Combination injectable contraceptives for contraception.

Maria F Gallo1, David A Grimes, Laureen M Lopez

  • 1Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

The Cochrane Database of Systematic Reviews
|May 4, 2013
PubMed
Summary
This summary is machine-generated.

Combination injectable contraceptives (CICs) offer effective pregnancy prevention but can lead to discontinuation due to bleeding issues. Norethisterone enanthate plus estradiol valerate showed better bleeding profiles than depot medroxyprogesterone acetate plus estradiol cypionate.

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Area of Science:

  • Reproductive Health
  • Contraception Research
  • Clinical Trials

Background:

  • Combination injectable contraceptives (CICs) are effective, reversible, and do not require coitus-dependent use.
  • Acceptability may be limited by injection frequency and bleeding pattern changes.

Purpose of the Study:

  • To assess contraceptive efficacy, bleeding patterns, discontinuation rates, user preferences, and side effects of CICs.
  • To compare different formulations of CICs and their impact on user experience.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) published up to February 2013.
  • Searched multiple databases including MEDLINE, POPLINE, CENTRAL, EMBASE, LILACS, ClinicalTrials.gov, and ICTRP.
  • Extracted data on efficacy, bleeding, continuation, and side effects; used survival analysis for discontinuation.

Main Results:

  • Twelve RCTs were included, comparing various CICs and other contraceptive methods.
  • CICs had lower early discontinuation due to amenorrhea than progestin-only contraceptives, but higher overall discontinuation.
  • Norethisterone enanthate (NET-EN) plus estradiol valerate (E2V) showed more regular bleeding and fewer prolonged bleeding periods compared to depot medroxyprogesterone acetate (DMPA) plus estradiol cypionate (E2C).

Conclusions:

  • Discontinuation rates are a proxy for acceptability but influenced by multiple factors.
  • Future research should focus on improving CIC acceptability through convenient administration and better counseling on bleeding patterns.