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Combined injectable contraceptives find high early acceptance
Jul 20, 2005, 15:07, Reviewed by: Dr.
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The Cochrane Review Authors found that injectable contraceptives that include medroxyprogesterone acetate (DMPA) and estradiol cypionate (E2C) were better tolerated than those containing DMPA alone. Both forms of contraception were highly effective at preventing pregnancy.
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By Cochrane Library,
Providing safe and effective contraception by injecting a mixture of progestins and oestrogens causes fewer side-effects than injecting progesterone-like chemicals alone.
Some women prefer not to take a contraceptive pill every day. For this reason researchers have created contraceptive options in which hormones are injected. These hormones are slowly released into the body, providing long-term contraception. One problem is that the constant supply of additional hormone can stop a woman experiencing monthly menstrual bleeding, and some women are disturbed by this lack of scheduled bleeding.
The Cochrane Review Authors found that injectable contraceptives that include medroxyprogesterone acetate (DMPA) and estradiol cypionate (E2C) were better tolerated than those containing DMPA alone. Both forms of contraception were highly effective at preventing pregnancy.
Along with the difference in composition, the two contraceptives have different patterns of use. While the combined injectable contraceptives are given once a month, the single-hormone version is injected every two or three months. In contrast with the single-hormone version in which women frequently have no menstrual bleeding, the monthly dosing with combined contraceptives causes levels of hormones to rise and fall in a monthly cycle, which in turn induces mild bleeding each month. This element of cyclical bleeding could be one of the reasons for its higher initial acceptance.
Over time, however, more people discontinue using the combined version than discontinue the single one.
It could be that the inconvenience of visiting a clinic every month for the next injection causes women to stop using combined injectable contraceptives. "Healthcare providers may need to think of other ways of providing the service to get over this problem," says lead author Maria Gallo, who works at Ipas in Chapel Hill, North Carolina. 
- Review Title: Gallo et al: Combination injectable contraceptives for contraception. The Cochrane Database of Systematic Reviews 2005 Issue 3
www.interscience.wiley.com
Cochrane reviews are based on the best available information about healthcare interventions. They explore the evidence for and against the effectiveness and appropriateness of treatments (medications, surgery, education, etc) in specific circumstances.
The complete reviews are published in The Cochrane Library which is available by subscription, either on CDROM or via the Internet. You should be able to browse the Cochrane Library at your nearest medical library if you don't have your own subscription.
The Cochrane Library is published four times a year. Each issue contains all existing reviews plus an increasingly wider range of new and updated reviews. It is published and distributed by Wiley InterScience and is also distributed by a number of other Distribution Partners. It is not available for sale from Cochrane Centres.
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