Dr. Sharda Jain

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Injectable Contraception
Dr. Sharda Jain Chairman, Dept of O/G -
Pushpanjali Crosslay Hospital Director Life
Care Centre Secretary Gen. Delhi Gynaecologist
Forum
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In India
DMPA currently approved and available in 106
countries and NET-EN in over 60 countries.
Approved by Drug Controller of India and
commercially available.
Some social marketing organizations also provide
ICs
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Continuation rate
Continuation rates with DMPA at the end of one
year 50-80, but as low as 19 in one Indian
study
Discontinuation due to
Amennorrhoea additional 11-12 for DMPA, 7-8
for NET-EN
Bleeding abnormalities 10-15 for both DMPA and
NET-EN.
For monthly injectables, continuation rates range
from 66 to 82.
Discontinuation due to
Bleeding abnormalities 7

Amenorrhoea 2
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Use of Contraceptive Methods

• Indias CPR is 48.2
• 67.7 in HP
• 24.5 in Bihar
• Major emphasis on sterilization (Limiting)
• Little use of spacing methods
• Use of traditional methods

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Injectable Contraception
Myths realities

• I. Risk of Malignancies
• Myth ? risk of Cancer
• Reality
• no risk of breast/endometrial/ovarian or cervical
  cancer with DMPA (WHO)
• II. CVS risk
• Myth Lipid metabolism coagulation changes
• Reality
• No statistically significant change in lipids
• No ? in Procoagulant factors
• No unfavouarable effect on BP.
• No case of CVA/MI/TE reported

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Injectable Contraception
Myths realities

• III Return to Fertility
• Myth delayed
• Reality
• No permanent impact on fertility
• 50 conceive within 10 m. of last injection
• IV Weight Mood Changes
• Myth Weight gain, depression
• Reality
• No depressive symptoms (Contraception 1997)
• No loss of libido (Contraception 1997)
• BMI changes 1.1 from baseline (Matson et al)

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Need of the day
Expanding Contraception Options to Meet
Reproductive Needs
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A baby should be born because it is wanted,
not because it cannot be prevented Dr. Sharda
Jain