Progestogen Only Injectables

Section 6: Progestogen Only Injectables


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Progestogen only injectables (POI) are widely used in the UK in the form of DMPA (depo medroxyprogesterone acetate) and NET-EN (norethisterone enantate); both are long-acting progestogens.  DMPA can be given as a deep intramuscular injection (Depo-Provera 150mg medroxyprogesterone acetate) or as a subcutaneous injection (Sayana Press 104mg medroxyprogesterone acetate).  NET-EN is rarely used in the UK.  It comes in an intramuscular injection (Noristerat 200mg) and has limited licensing indications.

POI is a highly effective long acting contraception, with failure rate of approximately 0.2% in the first year of use.  With typical use, however, failure rate increases to approximately 6%. POI contraception, like CHC, prevents ovulation.  It also interferes with cervical mucus production and endometrial proliferation.

As NET-EN is rarely used in the UK, the following guidance, based on FSRH guidance, concerns DMPA (unless stated).