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Progestin-only contraception: injectables and implants.

Roy Jacobstein1, Chelsea B Polis2

  • 1Engender Health, and Department of Maternal and Child Health, University of North Carolina Gillings School of Public Health, 440 Ninth Avenue, New York, NY 10001, USA.

Best Practice & Research. Clinical Obstetrics & Gynaecology
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PubMed
Summary
This summary is machine-generated.

Progestin-only contraceptives like injectables and implants are highly effective. New formulations and lower costs improve access, but menstrual changes and potential HIV links require careful consideration.

Keywords:
HIVdepot-medroxyprogesterone acetate (DMPA)hormonal contraceptionhormonal implantsinjectable contraceptionprogestin-only contraception

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Area of Science:

  • Reproductive Health
  • Contraception
  • Public Health

Background:

  • Progestin-only injectables and implants are effective, long-acting contraceptives used by many women globally.
  • Injectables are dominant in sub-Saharan Africa; implants offer the highest contraceptive effectiveness.
  • Recent developments include a lower-dose injectable formulation and reduced implant costs, improving accessibility.

Purpose of the Study:

  • To review the effectiveness and use of progestin-only contraceptives.
  • To discuss new formulations, cost reductions, and accessibility challenges.
  • To highlight common side effects, postpartum use considerations, and the controversial link to HIV acquisition.

Main Methods:

  • Literature review of progestin-only contraceptive injectables and implants.
  • Analysis of global usage patterns, particularly in sub-Saharan Africa.
  • Examination of formulation changes, cost-effectiveness, and associated health concerns.

Main Results:

  • Both methods are highly effective, with injectables prevalent in sub-Saharan Africa.
  • Menstrual bleeding changes are common and lead to discontinuation.
  • Controversy exists regarding association with HIV acquisition, particularly relevant for high-HIV burden regions.

Conclusions:

  • Progestin-only contraceptives are vital but require careful management of side effects and access issues.
  • Further research is needed on the controversial link between these methods and HIV acquisition.
  • Consideration of postpartum use and regional health burdens is crucial for effective family planning programs.