Key Points for Providers and Clients
  • Bleeding changes are common but not harmful. Typically, irregular bleeding for the first several months and then no monthly bleeding.
  • Return for injections regularly. Coming back every 3 months (13 weeks) for DMPA or every 2 months for NET-EN is important for greatest effectiveness.
  • Injection can be as much as 4 weeks late for DMPA or 2 weeks late for NET-EN. Even if later, she may still be able to have the injection.
  • Gradual weight gain is common, averaging 1-2 kg per year.
  • Return of fertility is often delayed. It takes several months longer on average to become pregnant after stopping progestin-only injectables than after stopping other methods.

What Are Progestin-Only Injectables?

  • The injectable contraceptives depot medroxyprogesterone acetate (DMPA) and norethisterone enanthate (NET-EN) each contain a progestin like the natural hormone progesterone in a woman’s body. (In contrast, monthly injectables contain both estrogen and progestin. See Monthly Injectables.)
  • Do not contain estrogen, and so can be used throughout breastfeeding, starting 6 weeks after giving birth, and by women who cannot use methods with estrogen.
  • Given by injection into the muscle (intramuscular injection) or, with a new formulation of DMPA, just under the skin (subcutaneous injection). The hormone is then released slowly into the bloodstream. (See DMPA for Subcutaneous Injection.)
  • DMPA, the most widely used progestin-only injectable, is also known in its intramuscular form as “the shot,” “the jab,” the injection, Depo, Depo-Provera, and Petogen. The subcutaneous version in the Uniject injection system is currently marketed under the name Sayana Press and in prefilled single-dose disposable hypodermic syringes as depo-subQ provera 104.
  • NET-EN is also known as norethindrone enanthate, Noristerat, Norigest,and Syngestal. (See Comparing Injectables for differences between DMPA and NET-EN.)
  • Work primarily by preventing the release of eggs from the ovaries (ovulation).

Progestin-Only Injectable Syringe and Vial