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Injectable Contraception: Current Practices and Future Trends

  • Family Planning (A Burke, Section Editor)
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Abstract

Injectable contraception includes progestin-only and combined estrogen and progestin agents that provide safe and highly effective birth control for one to three months. Injectable agents are widely available and play an important role in family planning programs worldwide. Depot medroxyprogesterone acetate, available for intramuscular injection and subcutaneous injection, is the best known and most broadly distributed injectable contraceptive agent, and is an ideal agent for women who have contraindications to estrogen use. Despite their effectiveness, progestin-only injectables are associated with high rates of discontinuation due to bothersome side effects including abnormal bleeding, health controversies including decreased bone mineral density, and increased risk of human immunodeficiency virus acquisition. Injectables do offer non-contraceptive benefits including symptom control related to endometriosis and fibroids, and decreased risk of endometrial cancer. Research is ongoing to determine new injectable hormone formulations that provide longer-acting contraceptive protection and fewer side effects.

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References

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  1. Bartz D, Goldberg A. Injectable Contraceptives. In: Hatcher R, Trussel J, Nelson A, Cates W, Kowal D, Policar M, editors. Contracept. Technol. 20th ed., Ardent Media; 2011, p. 209–36.

  2. Trussell J. Contraceptive failure in the United States. Contraception. 2011;83:397–404.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Kaunitz AM, Darney PD, Ross D, Wolter KD, Subcutaneous SL, DMPA. vs. intramuscular DMPA: a 2-year randomized study of contraceptive efficacy and bone mineral density. Contraception. 2009;80:7–17.

    Article  PubMed  CAS  Google Scholar 

  4. Draper B, Morroni C, Hoffman M, Smit J, Beksinska M. Hapgood J, et al. Cochrane Database Syst Rev: Depot medroxyprogesterone versus norethisterone oenanthate for long-acting progestogenic contraception; 2012.

    Google Scholar 

  5. Hall PE. New once-a-month injectable contraceptives, with particular reference to Cyclofem/Cyclo-Provera. Int J Gynaecol Obstet. 1998;62 Suppl 1:S43–56.

    Article  PubMed  Google Scholar 

  6. Guttmacher Institute. Contraceptive Use in the United States. New York, NY: Guttmacher Institute; 2014. Available via http://www.guttmacher.org/pubs/fb_contr_use.html.

  7. Jones J, Mosher W, Daniels K. Current contraceptive use in the United States, 2006–2010, and changes in patterns of use since 1995. National health statistics reports; no 60. vol. 1980. Hyattsville: National Center for Health Statistics; 2012.

    Google Scholar 

  8. Vaughan B, Trussell J, Kost K, Singh S, Jones R. Discontinuation and resumption of contraceptive use: results from the 2002 National Survey of Family Growth. Contraception. 2008;78:271–83.

    Article  PubMed Central  PubMed  Google Scholar 

  9. United Nations. World Contraceptive Patterns 2013. Population Division of the Department of Economic and Social Affairs. New York: 2013. Available at http://www.un.org/en/development/desa/population/publications/family/contraceptive-wallchart-2013.shtml.

  10. Ross JA, Agwanda AT. Increased use of injectable contraception in sub-Saharan Africa. Afr J Reprod Health. 2012;16:68–80.

    PubMed  Google Scholar 

  11. Lande R, Richey C. Expanding Services for Injectables. Population Reports, Series K, No. 6. Baltimore, MD: INFO Project, Johns Hopkins Bloomberg School of Public Health; 2006. Available at https://www.k4health.org/sites/default/files/k6.pdf.

  12. World Health Organization. Medical eligibility criteria for contraceptive use. 4th ed. Geneva, Switzerland: World Health Organization; 2009. Available at www.who.int/reproductivehealth. These are comprehensive worldwide evidence-based guidelines that identify who can safely use specific contraceptive methods.

  13. Centers for Disease Control and Prevention. U.S medical eligibility criteria for contraceptive use 2010: adapted from the World Health Organization medical eligibility criteria for contraceptive use, 4th ed. MMWR. 2010;59(RR-4):1–85. These are comprehensive evidence-based guidelines that identify who can safely use specific contraceptive methods in the United States.

    Google Scholar 

  14. United Nations Development Programme/United Nations Population Fund/World Health Organization/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Task Force on Long-acting Systemic Agents for Fertility Regulation. Comparative study of the effects of two once-a-month injectable contraceptives (Cyclofem® and Mesigyna®) and one oral contraceptive (Ortho-Novum 1/35®) on coagulation and fibrinolysis. Contraception. 2003;68:159–76.

    Article  CAS  Google Scholar 

  15. Centers for Disease Control and Prevention. U.S. selected practice recommendations for contraceptive use, 2013: adapted from the World Health Organization selected practice recommendations for contraceptive use, 2nd ed. MMWR. 2013;62(RR05):1–46. These are comprehensive evidence-based guidelines to identify how to use and prescribe contraceptive methods in the United States.

    Google Scholar 

  16. World Health Organization. Selected practice recommendations for contraceptive use, 2nd ed. Geneva, Switzerland: World Health Organization; 2004. Available at www.who.int/reproductivehealth.

  17. Pardthaisong T, Gray RH. In utero exposure to steroid contraceptives and outcome of pregnancy. Am J Epidemiol. 1991;134:795–803.

    PubMed  CAS  Google Scholar 

  18. Jensen E, Daniels J, Stürmer T, Robinson W, Williams C, Vejrup K, et al. Hormonal contraceptive use before and after conception in relation to preterm birth and small for gestational age: an observational cohort study. BJOG 2014:1–13.

  19. World Health Organization. Selected practice recommendations for contraceptive use, 2008 update. Geneva, Switzerland: World Health Organization; 2008. Available at www.who.int/reproductivehealth.

  20. Steiner MJ, Kwok C, Stanback J, Byamugisha JK, Chipato T, Magwali T, et al. Injectable contraception: what should the longest interval be for reinjections? 2008;77:410–4.

  21. Beasley A, White KO, Cremers S, Westhoff C. Randomized clinical trial of self versus clinical administration of subcutaneous depot medroxyprogesterone acetate. Contraception. 2014;89:352–6. This was the first randomized trial of DMPA-seeking women to determine feasibility and effectiveness of self-administration of DMPA-SC. Women in the self-administration group were able to correctly perform injections, had high levels of continuation, and via serum testing were shown to have appropriate and therapeutic systemic DMPA levels. The possibility of self-administration may have implications in expanding the national and international use of DMPA.

    Article  PubMed  CAS  Google Scholar 

  22. Stanback J, Spieler J, Shah I, Finger WR. Community-based health workers can safely and effectively administer injectable contraceptives: conclusions from a technical consultation. Contraception. 2010;81:181–4.

    Article  PubMed  Google Scholar 

  23. Malarcher S, Meirik O, Lebetkin E, Shah I, Spieler J, Stanback J. Provision of DMPA by community health workers: what the evidence shows. Contraception. 2011;83:495–503. This is a literature review demonstrating the safety and effectiveness of progestin-only injectable administration by community health workers. Implications include increasing worldwide access to injectable contraception, especially in developing countries.

    Article  PubMed  Google Scholar 

  24. Keith B. Home-based administration of depo-subQ provera 104™ in the Uniject™ injection system: A literature review. Seattle: 2011.

  25. PATH. Frequently Asked Questions About Sayana ® Press. Reproductive Global Health Program. Seattle: 2014. Available at http://www.path.org/publications/files/RH_sayana_press_faqs.pdf.

  26. Burke HM, Mueller MP, Packer C, Perry B, Bufumbo L, Mbengue D, et al. Provider acceptability of Sayana® Press: results from community health workers and clinic-based providers in Uganda and Senegal. Contraception. 2014;89:368–73.

    Article  PubMed  Google Scholar 

  27. Burke HM, Mueller MP, Perry B, Packer C, Bufumbo L, Mbengue D, et al. Observational study of the acceptability of Sayana® Press among intramuscular DMPA users in Uganda and Senegal. Contraception. 2014;89:361–7.

    Article  PubMed  Google Scholar 

  28. Brown J, Kives S. Akhtar M. Cochrane Database Syst Rev: Progestagens and anti-progestagens for pain associated with endometriosis; 2012.

    Google Scholar 

  29. Schlaff WD, Carson SA, Luciano A, Ross D, Bergqvist A. Subcutaneous injection of depot medroxyprogesterone acetate compared with leuprolide acetate in the treatment of endometriosis-associated pain. Fertil Steril. 2006;85:314–25.

    Article  PubMed  CAS  Google Scholar 

  30. Cheewadhanaraks S, Choksuchat C, Dhanaworavibul K, Liabsuetrakul T. Postoperative depot medroxyprogesterone acetate versus continuous oral contraceptive pills in the treatment of endometriosis-associated pain: a randomized comparative trial. Gynecol Obstet Invest. 2012;74:151–6.

    Article  PubMed  CAS  Google Scholar 

  31. Venkatachalam S, Bagratee JS, Moodley J. Medical management of uterine fibroids with medroxyprogesterone acetate (Depo Provera): a pilot study. J Obstet Gynaecol. 2004;24:798–800.

    Article  PubMed  CAS  Google Scholar 

  32. Sangkomkamhang U, Lumbiganon P, Laopaiboon M, BWJ M. Progestogens or progestogen-releasing intrauterine systems for uterine fibroids (Review). Cochrane Database Syst Rev 2013.

  33. Wise LA. Reproductive Factors, Hormonal Contraception, and Risk of Uterine Leiomyomata in African-American Women: A Prospective Study. Am J Epidemiol. 2004;159:113–23.

    Article  PubMed Central  PubMed  Google Scholar 

  34. Gomez Manchikanti A, Grimes D, Lopez L, Schulz K. Steroid hormones for contraception in women with sickle cell disease (Review). Cochrane Database Syst Rev 2007.

  35. Meirow D, Rabinovici J, Katz D, Or R, Shufaro Y, Ben-Yehuda D. Prevention of severe menorrhagia in oncology patients with treatment-induced thrombocytopenia by luteinizing hormone-releasing hormone agonist and depo-medroxyprogesterone acetate. Cancer. 2006;107:1634–41.

    Article  PubMed  CAS  Google Scholar 

  36. Sönmezer M, Atabekoğlu C, Cengiz B, Dökmeci F, Cengiz SD. Depot-medroxyprogesterone acetate in anticoagulated patients with previous hemorrhagic corpus luteum. Eur J Contracept Reprod Health Care. 2005;10:9–14.

    Article  PubMed  CAS  Google Scholar 

  37. MacGregor EA. Contraception and headache. Headache. 2013;53:247–76.

    Article  PubMed  Google Scholar 

  38. Bäckström T, Zetterlund B, Blom S, Romano M. Effects of intravenous progesterone infusions on the epileptic discharge frequency in women with partial epilepsy. Acta Neurol Scand. 1984;69:240–8.

    Article  PubMed  Google Scholar 

  39. Schwenkhagen AM, Stodieck SRG. Which contraception for women with epilepsy? Seizure. 2008;17:145–50.

    Article  PubMed  Google Scholar 

  40. Thomas D, Ray R. Depot-medroxyprogesterone acetate (DMPA) and risk of endometrial cancer. The WHO Collaborative Study of Neoplasia and Steroid Contraceptives. Int J Cancer. 1991;49:186–90.

    Article  Google Scholar 

  41. The WHO Collaborative Study of Neoplasia and Steroid Contraceptives. Depot-medroxyprogesterone acetate (DMPA) and risk of epithelial ovarian cancer. Int J Cancer. 1991;49:191–5.

    Article  Google Scholar 

  42. Wilailak S, Vipupinyo C, Suraseranivong V, Chotivanich K, Kietpeerakool C, Tanapat Y, et al. Depot medroxyprogesterone acetate and epithelial ovarian cancer: a multicentre case-control study. BJOG. 2012;119:672–7.

    Article  PubMed  CAS  Google Scholar 

  43. Harris TG, Miller L, Kulasingam SL, Feng Q, Kiviat NB, Schwartz SM, et al. Depot-medroxyprogesterone acetate and combined oral contraceptive use and cervical neoplasia among women with oncogenic human papillomavirus infection. Am J Obstet Gynecol. 2009;200:489.e1–8.

    Article  CAS  Google Scholar 

  44. Castle PE, Walker JL, Schiffman M, Wheeler CM. Hormonal contraceptive use, pregnancy and parity, and the risk of cervical intraepithelial neoplasia 3 among oncogenic HPV DNA-positive women with equivocal or mildly abnormal cytology. Int J Cancer. 2005;117:1007–12.

    Article  PubMed  CAS  Google Scholar 

  45. Shapiro S, Rosenberg L, Hoffman M, Kelly JP, Cooper DD, Carrara H, et al. Risk of invasive cancer of the cervix in relation to the use of injectable progestogen contraceptives and combined estrogen/progestogen oral contraceptives (South Africa). Cancer Causes Control. 2003;14:485–95.

    Article  PubMed  Google Scholar 

  46. Skegg DC, Noonan EA, Paul C, Spears GF, Meirik O, Thomas DB. Depot medroxyprogesterone acetate and breast cancer. A pooled analysis of the World Health Organization and New Zealand studies. JAMA. 1995;273:799–804.

    Article  PubMed  CAS  Google Scholar 

  47. Li CI, Beaber EF, Tang MTC, Porter PL, Daling JR, Malone KE. Effect of depo-medroxyprogesterone acetate on breast cancer risk among women 20 to 44 years of age. Cancer Res. 2012;72:2028–35.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  48. Strom BL, Berlin JA, Weber AL, Norman SA, Bernstein L, Burkman RT, et al. Absence of an effect of injectable and implantable progestin-only contraceptives on subsequent risk of breast cancer. Contraception. 2004;69:353–60.

    Article  PubMed  CAS  Google Scholar 

  49. Hubacher D, Lopez L, Steiner MJ, Dorflinger L. Menstrual pattern changes from levonorgestrel subdermal implants and DMPA: systematic review and evidence-based comparisons. Contraception. 2009;80:113–8.

    Article  PubMed  CAS  Google Scholar 

  50. Arias RD, Jain JK, Brucker C, Ross D, Ray A. Changes in bleeding patterns with depot medroxyprogesterone acetate subcutaneous injection 104 mg. Contraception. 2006;74:234–8.

    Article  PubMed  CAS  Google Scholar 

  51. Moreau C, Cleland K, Trussell J. Contraceptive discontinuation attributed to method dissatisfaction in the United States. Contraception. 2007;76:267–72.

    Article  PubMed  Google Scholar 

  52. Canto De Cetina TE, Canto P, Ordoñez Luna M. Effect of counseling to improve compliance in Mexican women receiving depot-medroxyprogesterone acetate. Contraception. 2001;63:143–6.

    Article  PubMed  CAS  Google Scholar 

  53. Abdel-Aleem H, D’Arcangues C, Vogelsang K, Gaffield M, Gulmezoglu A. Treatment of vaginal bleeding irregularities induced by progestin only contraceptives. Cochrane Database Syst Rev 2013. Summary of interventions for prevention of abnormal bleeding and treatment of acute bleeding with DMPA use.

  54. Dempsey A, Roca C, Westhoff C. Vaginal estrogen supplementation during Depo-Provera initiation: a randomized controlled trial. Contraception. 2010;82:250–5.

    Article  PubMed  CAS  Google Scholar 

  55. Jain J. Mifepristone for the prevention of breakthrough bleeding in new starters of depo-medroxyprogesterone acetate. Steroids. 2003;68:1115–9.

    Article  PubMed  CAS  Google Scholar 

  56. Said S, Sadek W, Rocca M, Koetsawang S, Kirwat O, Piya-Anant M, et al. Clinical evaluation of the therapeutic effectiveness of ethinyl oestradiol and oestrone sulphate on prolonged bleeding in women using depot medroxyprogesterone acetate for contraception. World Health Organization, Special Programme of Research, Development and Research Training in Human Reproduction, Task Force on Long-acting Systemic Agents for Fertility Regulation. Hum Reprod. 1996;11 Suppl 2:1–13.

    Article  PubMed  CAS  Google Scholar 

  57. Nathirojanakun P, Taneepanichskul S, Sappakitkumjorn N. Efficacy of a selective COX-2 inhibitor for controlling irregular uterine bleeding in DMPA users. Contraception. 2006;73:584–7.

    Article  PubMed  CAS  Google Scholar 

  58. Tantiwattanakul P, Taneepanichskul S. Effect of mefenamic acid on controlling irregular uterine bleeding in DMPA users. Contraception. 2004;70:277–9.

    Article  PubMed  CAS  Google Scholar 

  59. Senthong A, Taneepanichskul S. The effect of tranexamic acid for treatment of irregular uterine bleeding secondary to DMPA use. J Med Assoc Thail. 2009;92:461–5.

    Google Scholar 

  60. Abdel-Aleem H, Shaaban OM, Abdel-Aleem MA, Fetih GN. Doxycycline in the treatment of bleeding with DMPA: a double-blinded randomized controlled trial. Contraception. 2012;86:224–30.

    Article  PubMed  CAS  Google Scholar 

  61. Gallo M, Grimes D, Lopez L, Schulz K. D’Arcangues C. Cochrane Database Syst Rev: Combination injectable contraceptives for contraception; 2008.

    Google Scholar 

  62. Paulen ME, Curtis KM. When can a woman have repeat progestogen-only injectables–depot medroxyprogesterone acetate or norethisterone enantate? Contraception. 2009;80:391–408.

    Article  PubMed  CAS  Google Scholar 

  63. Jain J, Dutton C, Nicosia A, Wajszczuk C, Bode FR, Mishell DR. Pharmacokinetics, ovulation suppression and return to ovulation following a lower dose subcutaneous formulation of Depo-Provera. Contraception. 2004;70:11–8.

    Article  PubMed  CAS  Google Scholar 

  64. Kaunitz AM. Injectable contraception. New and existing options. Obstet Gynecol Clin N Am. 2000;27:741–80.

    Article  CAS  Google Scholar 

  65. Queenan JT. Contraception and breastfeeding. Clin Obstet Gynecol. 2004;47:734–9.

    Article  PubMed  Google Scholar 

  66. Truitt S, Fraser A, Gallo M, Lopez L, Grimes D. Schulz K. Cochrane Database Syst Rev: Combined hormonal versus nonhormonal versus progestin- only contraception in lactation; 2010.

    Google Scholar 

  67. Snyder AM, Hull EM. Perinatal progesterone affects learning in rats. Psychoneuroendocrinology. 1980;5:113–9.

    Article  PubMed  CAS  Google Scholar 

  68. American College of Obstetricians and Gynecologists. Depot medroxyprogesterone acetate and bone effects. Committee Opinion No. 602. Obstet Gynecol. 2014;123:1398–402.

    Article  CAS  Google Scholar 

  69. US Food and Drug Administration. Depo-Provera Physician Information. 2004. Available at http://www.accessdata.fda.gov/drugsatfda_docs/label/2004/20246s025lbl.pdf.

  70. Lanza LL, McQuay LJ, Rothman KJ, Bone HG, Kaunitz AM, Harel Z, et al. Use of depot medroxyprogesterone acetate contraception and incidence of bone fracture. Obstet Gynecol. 2013;121:593–600. Large retrospective study demonstrating an increased baseline fracture risk in DMPA users, but no increased risk of fragility fracture after DMPA initiation, suggesting the reversible bone mineral density loss may be of minimal clinical significance in healthy DMPA users.

    Article  PubMed  CAS  Google Scholar 

  71. Kaunitz AM, Arias R, McClung M. Bone density recovery after depot medroxyprogesterone acetate injectable contraception use. Contraception. 2008;77:67–76.

    Article  PubMed  CAS  Google Scholar 

  72. Møller UK, Við Streym S, Mosekilde L, Rejnmark L. Changes in bone mineral density and body composition during pregnancy and postpartum. A controlled cohort study. Osteoporos Int. 2012;23:1213–23.

    Article  PubMed  Google Scholar 

  73. Lopez L, Grimes D, Schulz K, Curtis D. Chen M. Cochrane Database Syst Rev: Steroidal contraceptives effect on bone fractures in women; 2014.

    Google Scholar 

  74. Guilbert ER, Brown JP, Kaunitz AM, Wagner M-S, Bérubé J, Charbonneau L, et al. The use of depot-medroxyprogesterone acetate in contraception and its potential impact on skeletal health. Contraception. 2009;79:167–77.

    Article  PubMed  CAS  Google Scholar 

  75. Vickery Z, Madden T, Zhao Q, Secura GM, Allsworth JE, Peipert JF. Weight change at 12 months in users of three progestin-only contraceptive methods. Contraception. 2013;88:503–8. Prospective study comparing weight gain among hormonal and non-hormonal contraceptive users; adjusted analysis demonstrates no significant increased weight gain among progestin-only injectables, etonogestrel implants, levonorgestrel intrauterine systems and copper intrauterine devices.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  76. Tuchman LK, Huppert JS, Huang B, Slap GB. Adolescent use of the monthly contraceptive injection. J Pediatr Adolesc Gynecol. 2005;18:255–60.

    Article  PubMed  Google Scholar 

  77. Westhoff C, Jain JK, Milsom I, Ray A. Changes in weight with depot medroxyprogesterone acetate subcutaneous injection 104 mg/0.65 mL. Contraception. 2007;75:261–7.

    Article  PubMed  CAS  Google Scholar 

  78. Le YL, Rahman M, Berenson AB. Early weight gain predicting later weight gain among depot medroxyprogesterone acetate users. Obstet Gynecol. 2009;114:279–84.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  79. Curtis KM, Ravi A, Gaffield ML. Progestogen-only contraceptive use in obese women. Contraception. 2009;80:346–54.

    Article  PubMed  CAS  Google Scholar 

  80. Bonny AE, Secic M, Cromer BA. A longitudinal comparison of body composition changes in adolescent girls receiving hormonal contraception. J Adolesc Health. 2009;45:423–5.

    Article  PubMed Central  PubMed  Google Scholar 

  81. Berenson AB, Rahman M. Changes in weight, total fat, percent body fat, and central-to-peripheral fat ratio associated with injectable and oral contraceptive use. Am J Obstet Gynecol. 2009;200:329.e1–8.

    Article  CAS  Google Scholar 

  82. Lopez L, Grimes D, Schulz K. Steroidal contraceptives: effect on carbohydrate metabolism in women without diabetes mellitus. Cochrane Database Syst Rev 2014.

  83. Segall-Gutierrez P, Xiang AH, Watanabe RM, Trigo E, Stanczyk FZ, Liu X, et al. Deterioration in cardiometabolic risk markers in obese women during depot medroxyprogesterone acetate use. Contraception. 2012;85:36–41.

    Article  PubMed  CAS  Google Scholar 

  84. Lopez L, Grimes D, Chen M, Otterness C, Westhoff C. Edelman A, et al. Cochrane Database Syst Rev: Hormonal contraceptives for contraception in overweight or obese women; 2013.

    Google Scholar 

  85. Polis CB, Curtis KM. Use of hormonal contraceptives and HIV acquisition in women: a systematic review of the epidemiological evidence. Lancet Infect Dis. 2013;13:797–808.

    Article  PubMed  Google Scholar 

  86. World Health Organization. Hormonal contraceptive methods for women at high risk of HIV and living with HIV. 2014 Guidance Statement. World Health Organization. Geneva: 2014. Available at http://www.who.int/reproductivehealth/publications/family_planning/HC_and_HIV_2014/en/. WHO literature review demonstrating no current evidence suggestive of increased acquisition, progression, or transmission of HIV among progestin-only injectable users. The recommendation is not to limit this method for women with or at risk for HIV infection as the benefits outweigh the risks.

  87. Butler AR, Smith JA, Polis CB, Gregson S, Stanton D, Hallett TB. Modelling the global competing risks of a potential interaction between injectable hormonal contraception and HIV risk. AIDS. 2013;27:105–13.

    Article  PubMed  CAS  Google Scholar 

  88. Robinson JA, Jamshidi R, Burke AE. Contraception for the HIV-positive woman: a review of interactions between hormonal contraception and antiretroviral therapy. Infect Dis Obstet Gynecol. 2012;2012.

  89. Berenson AB, Odom SD, Breitkopf CR, Rahman M. Physiologic and psychologic symptoms associated with use of injectable contraception and 20 microg oral contraceptive pills. Am J Obstet Gynecol. 2008;199:351.e1–12.

    Article  CAS  Google Scholar 

  90. Westhoff C, Truman C, Kalmuss D, Cushman L, Davidson A, Rulin M, et al. Depressive symptoms and Depo-Provera. Contraception. 1998;57:237–40.

    Article  PubMed  CAS  Google Scholar 

  91. Gupta N, O’Brien R, Jacobsen LJ, Davis A, Zuckerman A, Supran S, et al. Mood changes in adolescents using depot-medroxyprogesterone acetate for contraception: a prospective study. J Pediatr Adolesc Gynecol. 2001;14:71–6.

    Article  PubMed  CAS  Google Scholar 

  92. Civic D, Scholes D, Ichikawa L, Lacroix AZ, Yoshida CK, Ott SM, et al. Depressive Symptoms in Users and Non-Users of Depot Medroxyprogesterone Acetate. Contraception. 2000;61:385–90.

    Article  PubMed  CAS  Google Scholar 

  93. Tsai R, Schaffir J. Effect of depot medroxyprogesterone acetate on postpartum depression. Contraception. 2010;82:174–7.

    Article  PubMed  CAS  Google Scholar 

  94. Seven A, Yüksel B, Kılıç S, Esen H, Keskin U, Ulubay M, et al. Effect of injectable medroxyprogesterone acetate and etonogestrel implants on GABA-A and serotonin receptors in white and gray matter of the brain: experimental study in rats. Gynecol Endocrinol. 2014;30:320–4.

    Article  PubMed  CAS  Google Scholar 

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Kristen Wolfe declares that she has no conflict of interest.

Catherine Cansino reports that she is part of the speaker's bureau for Merck.

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  1. Department of Obstetrics and Gynecology, University of California, Davis, 4860 Y Street, Suite 2500, Sacramento, CA, 95817, USA

    Kristen Wolfe & Catherine Cansino

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Correspondence to Catherine Cansino.

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Wolfe, K., Cansino, C. Injectable Contraception: Current Practices and Future Trends. Curr Obstet Gynecol Rep 4, 26–36 (2015). https://doi.org/10.1007/s13669-014-0106-7

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