CHAPTER 5 - Monthly Injectables

Key Points for Providers and Clients
  • Bleeding changes are common but not harmful. Typically, lighter monthly bleeding, fewer days of bleeding, or irregular or infrequent bleeding.
  • Return on time. Coming back every 4 weeks is important for greatest effectiveness.
  • Injection can be as much as 7 days early or late. Client should come back even if later.

What Are Monthly Injectables?

  • Monthly injectables contain 2 hormones—a progestin and an estrogen—like the natural hormones progesterone and estrogen in a woman’s body. (Combined oral contraceptives also contain these 2 types of hormones.)
  • Also called combined injectable contraceptives, CICs, the injection.
  • Information in this chapter applies to medroxyprogesterone acetate (MPA)/estradiol cypionate and to norethisterone enanthate (NET-EN)/estradiol valerate. The information may also apply to older formulations, about which less is known.
  • MPA/estradiol cypionate is marketed under the trade names Ciclofem, Ciclofemina, Cyclofem, Cyclo-Provera, Feminena, Lunella, Lunelle, Novafem, and others. NET-EN/estradiol valerate is marketed under the trade names Mesigyna and Norigynon.
  • Work primarily by preventing the release of eggs from the ovaries (ovulation).
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