Injectable contraception and subdermal implants Terms in this set (14) Progesterone only injectables Injectables Mode of action o Primarily inhibits ovulation by blocking the LH surge. o Thickening of the cervical mucus and thereby preventin

Injectable contraception and subdermal implants Terms in this set (14) Progesterone only injectables Injectables Mode of action o Primarily inhibits ovulation by blocking the LH surge. o Thickening of the cervical mucus and thereby preventing sperm penetration. o Altering the endometrial lining to a hypo trophic or atrophic state, which cannot support implantation or pregnancy. o Reducing tubal motility and sperm migration. Contraindications o Pregnancy. o Unexplained vaginal bleeding. o Severe coagulation disorders. o Hepatic disorders (previous sex steroid induced liver adenoma) Side effects o Menstrual changes: Irregular, prolonged bleeding or spotting and heavy bleeding. o Amenorrhoea (increases with duration of use). o Increased appetite, weight gain. o Acne, headache, mood changes and dizziness. o Delay in fertility return: Average is 4 - 6 months. o Decrease in libido. Injectable contraception and subdermal implants Indications to consider injectable progesterone o At least 1 year birth spacing desired. o Highly effective method required. o Long acting contraceptive desired. o Private method desired. o Estrogen free method needed. o Breastfeeding. o Sickle cell disease or other reasons for anaemia. o Epilepsy. o Suppression of menstrual bleeding. Duration of use No restrictions, but take care with adolescents younger than 18 years and woman older than 45 years, due to a reduce in bone mineral density. Return of fertility o There is an average delay of fertility of 4 - 6 months, sooner for NET-EN than for DMPA even with long term use. o DMPA: 6 - 8 months (longer if BMI), menstruation after 6 months and ovulation after 14 weeks. Key characteristics of injectables Timing Late dates Drug interactions Subdermal Implants Implanon Key characteristics of implants