Combined injectable contraceptive
| Combined Injectable Contraceptive | |
|---|---|
| Background | |
| Type | Hormonal | 
| First use | about 1980 | 
| Failure rates (first year) | |
| Perfect use | 0-0.2%[1] | 
| Typical use | ? | 
| Usage | |
| Duration effect | 1 month | 
| User reminders | ? | 
| Advantages and disadvantages | |
| STD protection | No | 
| Benefits | Especially good if poor pill compliance. | 
Combined injectable contraceptive (CIC) monthly injection of a progestin and an estrogen taken to suppress fertility. Brand names include Cyclofem, Novafem, Mesigyna, Lunelle and Cyclo-Provera.
Depot medroxyprogesterone acetate (DMPA) is a different injectable contraceptive, containing just a progestin, given every three months. It is a progestogen-only injectable contraceptive.
Hormonal contraception works primarily by preventing ovulation, but it may also thicken the cervical mucus inhibiting sperm penetration.[2][3][4] Hormonal contraceptives also have effects on the endometrium,[5][6] that theoretically could affect implantation,[7][8][9][10]
List of CICs
CICs that have been marketed include the following:[11][12][13]
- Hydroxyprogesterone caproate 250 mg and estradiol valerate 5 mg ("Chinese Injectable Number 1") – available in China
 - Dihydroxyprogesterone acetophenide 150 mg and estradiol enanthate 10 mg (Deladroxate, Perlutal, Topasel, Perlutan) – available in Latin America and Spain
 - Medroxyprogesterone acetate 25 mg and estradiol cypionate 5 mg (Cyclo-Provera, Cyclofem, Feminena, Lunelle, Novafem)
 - Norethisterone enanthate 50 mg and estradiol valerate 5 mg (Mesigyna)
 - Megestrol acetate 25 mg and estradiol 3.5 mg (Mego-E)
 
Medical uses
CIC is administered by intramuscular injection into the deltoid, gluteus maximus, or anterior thigh.[1] It is ideally administered every 28 to 30 days, though it has been demonstrated to be effective up to 33 days.[1]
Side-effects
The most prominent side effects are menstrual irregularities during the first 3 to 6 months of use.[1]
History
- October 5, 2000, Pharmacia received FDA approval for Lunelle Monthly Contraceptive Injection.[1]
 - April 2003, Pharmacia acquired by Pfizer (makers of Depo-Provera (DMPA)).
 - October 2003, Lunelle was discontinued in the U.S.
 
See also
- Concept Foundation
 - Extended cycle combined hormonal contraceptive
 - Depo-Provera, a Long-acting reversible contraceptive that is injected every 3 months.
 - Progestogen-only injectable contraceptive
 - Reproductive Health Supplies Coalition
 - Estradiol-containing oral contraceptive
 
Footnotes
- 1 2 3 4 5 "FDA Approves Combined Monthly Injectable Contraceptive". Contraception Report. 12 (3). 2001. Archived from the original on September 26, 2006.
 - ↑ Tamara Callahan MD , Aaron Caughey MD , Blueprints Obstetrics and Gynecology, 2013
 - ↑ KD Tripathi , Essentials of Medical Pharmacology, 2013
 - ↑ Dc Dutta's Textbook of Obstetrics, 2014
 - ↑ K. A. Petrie, A. H. Torgal, C. L. Westhoff, Matched-pairs analysis of ovarian suppressionduring oral vs. vaginal hormonal contraceptive use, „Contraception” 2011, t. 84, p. e2-3
 - ↑ R. L. Birtch, O. A. Olatunbosum, R. A. Pierson, Ovarian follicular dynamics during conventional vs continuous oral contraceptive use, „Contraception” 2006, t. 73, p. 235. p. 239.
 - ↑ K. Bugge, K. S. Richter, J. Bromer, et al., Pregnancy rates following in vitro fertilization are reduced with a thin endometrium, but are unrelated to endometrial thickness above 10 millimeters,„Fertility and Sterility” 2004, t. 82, p. S199.
 - ↑ T. Fiumino, A. Kuwata, A. Teranischi et al., Significance of endometrium thickness to evaluate endometrial receptivity for embryos in natural cycle, „Fertility and Sterility” 2008, t. 90,p. S159.
 - ↑ K. S. Richter, K. R. Bugge, J. G. Bromer, Relationship between endometrial thickness and embryo implantation, based on 1. 294 cycles of in vitro fertilization with transfer of two blastocyst-stage embryos, „Fertility and Sterility” 2007, t. 87, p. 53.
 - ↑ Rivera R, Yacobson I, Grimes D (1999). "The mechanism of action of hormonal contraceptives and intrauterine contraceptive devices". Am J Obstet Gynecol. 181 (5 Pt 1): 1263–9. doi:10.1016/S0002-9378(99)70120-1. PMID 10561657.
 - ↑ Newton JR, D'arcangues C, Hall PE (1994). "A review of "once-a-month" combined injectable contraceptives". J Obstet Gynaecol (Lahore). 4 Suppl 1: S1–34. doi:10.3109/01443619409027641. PMID 12290848.
 - ↑ http://www.wjpps.com/download/article/1412071798.pdf
 - ↑ Rowlands, S (2009). "New technologies in contraception". BJOG: An International Journal of Obstetrics & Gynaecology. 116 (2): 230–239. doi:10.1111/j.1471-0528.2008.01985.x. ISSN 1470-0328.