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Long-acting steroidal contraception: an update.

C W Bardin1

  • 1Center for Biomedical Research, Population Council, New York, New York.

International Journal of Fertility
|January 1, 1989
PubMed
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This summary is machine-generated.

Long-acting contraceptives like injections and implants offer highly effective, reversible birth control. While injectables like DMPA and NET-EN are convenient, menstrual disruption is a common side effect, unlike some once-a-month options.

Area of Science:

  • Reproductive Health
  • Contraception Technology
  • Pharmacology

Background:

  • Long-acting injectable contraceptives emerged in the 1960s, with millions currently using methods like depo-medroxyprogesterone acetate (DMPA) and norethindrone enanthate (NET-EN).
  • Injectable contraceptives offer high efficacy, coital independence, and facilitate regular healthcare contact, though this frequency can be a drawback for some.

Purpose of the Study:

  • To review the efficacy, advantages, and disadvantages of long-acting injectable and implantable contraceptive methods.
  • To compare the side effect profiles, particularly menstrual disruption, between different long-acting contraceptive formulations.

Main Methods:

  • Review of existing literature on long-acting injectable and implantable contraceptives.
  • Analysis of user statistics and reported efficacy and side effect data for methods like DMPA, NET-EN, and Norplant.
Keywords:
Biodegradable Delivery SystemsBiologyCervical Mucus--changesCervixContraceptionContraception Termination--indicationsContraceptive Agents, Female--analysisContraceptive Agents, Progestin--analysisContraceptive Agents--analysisContraceptive EffectivenessContraceptive ImplantsContraceptive MethodsContraceptive Mode Of ActionContraceptive UsageDemographic FactorsDiseasesExaminations And DiagnosesFamily PlanningFertilityFertility MeasurementsGenitaliaGenitalia, FemaleHemic SystemHemoglobin LevelInjectablesLevonorgestrel--analysisMeasurementMenstruation DisordersMethod AcceptabilityOvulation SuppressionPhysiologyPopulationPopulation DynamicsPregnancy ComplicationsPregnancy RatePregnancy, EctopicResearch MethodologyUrogenital SystemUse-effectivenessUterus

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Main Results:

  • Injectable contraceptives are highly effective, with progestin-only formulations like DMPA and NET-EN commonly causing menstrual irregularities.
  • Once-a-month injectables show fewer discontinuations due to menstrual disruption.
  • The Norplant implant system demonstrated a low failure rate (4-5 per 1000 users/year) over 5 years, significantly lower than oral contraceptives, with menstrual cycle disruption being the primary side effect.

Conclusions:

  • Long-acting contraceptives, including injectables and implants, provide effective pregnancy prevention with varying side effect profiles.
  • Menstrual disruption is a key consideration for progestin-only injectables, while implants offer user-controlled reversibility.
  • The Norplant implant represents a highly effective long-term contraceptive option with a manageable side effect profile.