Parenteral progestogen-only contraception (community and hospital)

Depo-provera^® (medroxyprogesterone acetate) is a long-acting progestogen given by IM injection., It is as effective as the combined oral contraceptive pill but because of its prolonged action should never be given without full counselling. It should only be used in adolescents if all other methods are inappropriate. In all women, the benefits beyond 2 years should be fully evaluated. Consider other contraceptives in women at high risk of osteoporosis.

Sayana Press^® (medroxyprogesterone acetate) is a long acting progestogen given by SC injection. It provides contraception for 13 weeks. It may be suitable for self administration where appropriate however the first dose must always be given by a health care professional and the patient trained in the administration technique and also fully counselled regarding long acting contraception.

Nexplanon (etonogestrel implant) is a highly effective contraceptive consisting of a single flexible rod that is inserted subdermally into the lower surface of the upper arm and provides contraception for up to 3 years. In heavier women the implant may not provide effective contraception in the 3rd year and the manufacturers advise that earlier replacement may be considered. A doctor or nurse fully trained in the implantation technique must administer the implant and provide full counselling and an information leaflet.