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Contraceptive injection

What is a contraceptive injection?

An injection which reduces the risk of pregnancy and can reduce or stop menstruation.

It's also known as Medroxyprogesterone acetate, MPA, Depo-Provera, or Sayana Press.

The same hormones used in the contraceptive implant can also be used for other purposes; see progesterone, contraceptive implant.

What does a contraceptive injection do?

How long does a contraceptive injection last?

The contraceptive injection must be administered regularly, most commonly every 12 weeks. It may take significant time for fertility to return after the medication is stopped.

What should I be aware of?

The contraceptive injection has a very high effectiveness, but there is still a small (<1%) chance of pregnancy, which is increased if repeat injections are not given at the correct times 1. Some medicines may make the injection less effective 2. Combining the implant with the use of barrier methods such as a condom will reduce the risk of pregnancy even further.

Contraceptive injections are normally only offered to people under the age of 18 after alternative methods of contraception have been discussed and ruled out 1;2.

Why might I want a contraceptive injection?

A contraceptive injection substantially reduces the risk of pregnancy for several months after it is given. Unlike the contraceptive pill, you do not need to remember to take a pill every day.

For many people the contraceptive injection reduces menstruation (periods) and menstrual pain. For around 3 in 10 people, it stops menstruation entirely, increasing to around 6 in 10 after several years of use 2.

A contraceptive injection may be less likely to be seen or felt than a contraceptive implant.

If you are using testosterone, the contraceptive injection is believed to be a better choice than the combined contraceptive pill 3.

Why might I not want a contraceptive injection?

Some people decide they do not want the injection because they experience side effects such as weight gain, heavy bleeding, and headaches. However, not everyone will experience these side effects.

Use of the contraceptive injection may affect bone density. As a result of this, other methods of contraception are normally preferred for people who are under 18 or over the age of 50 1.

It can take considerable time for fertility to return again after stopping contraceptive injections, in some cases up to a year or more 2. If you are planning to become pregnant soon, another contraceptive option may be a better option for you.

Are there other options?

Other options that can also be used while taking testosterone include a contraceptive implant, progesterone-only contraceptive pills, and most types of IUD 3.

If you are not using testosterone, other options also include the combined contraceptive pill, patches, and vaginal rings. You can read more about what types of contraception are right for you on the Contraception Choices website.

How do I get a contraceptive injection?

You can ask for contraceptive injections at most GP surgeries, sexual health clinics, and GUM clinics.

You will need to return for more injections at regular intervals. How long you will wait between injections depends on the exact brand you are given, but it is normally every 2-3 months.

How much does it cost?

You can receive contraceptive injections for free at an NHS GP surgery, sexual health, or GUM clinic.

Where can I learn more?

You can read more about the contraceptive injection on the NHS website.

You can find more information about contraception specifically for transgender and non-binary people on the FSRH website.

References

  1. 1.
    Faculty of Sexual and Reproductive Healthcare (2014) “Progestogen-only Injectable Contraception.” Link
  2. 2.
    Electronic Medicines Compendium (2020) “Depo-Provera 150mg/ml Injection Sterile suspension for injection.” Link
  3. 3.
    FSRH Clinical Effectiveness Unit (2017) “Contraceptive Choices and Sexual Health for Transgender and Non-binary People.” Link

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