Progestogen-only long-acting injectable contraceptive
Updated · Methodology
Second line
Contraception for women who find daily pills inconvenient and dislike implants or IUDs. Per SEGO 2023, second-line due to BMD reduction and delayed fertility return. Pearl Index 0.2 perfect-use. Especially valuable in endometriosis and sickle cell disease (reduces crises).
Sources
ICD-10: Z30.0 · ICD-11: QA21
First line
Contraception during breastfeeding. MEC 2015 category 1 from day 1 postpartum. Does not reduce milk supply. RID about 1%, Hale L1. Good option if daily pill-taking is unacceptable.
Sources
ICD-10: Z30.0 · ICD-11: QA21
Intramuscular 150 mg or subcutaneous 104 mg injection every 3 months. Suppresses ovulation via gonadotropin suppression. Delayed fertility return – median 10 months after last injection. Reduces bone mineral density with long-term use – per black box, no more than 2 years without reassessment.
Boxed warning
FDA black box: prolonged use beyond 2 years lowers BMD with possibly incomplete recovery. Use cautiously in teens and women at risk for osteoporosis.
Do not administer in pregnancy.
WHO MEC 2015 category 1 from day 1 postpartum. Does not reduce milk supply. Medroxyprogesterone RID about 1%, Hale L1.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Opens the checker prefilled with this drug. Pick the second one from your regimen.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Medroxyprogesterone acetate depot is evaluated for the following indications with varying evidence strength: Contraception (evidence tier A), Contraception during breastfeeding (evidence tier A). See the full indication matrix with dosing and citations above on this page.
Common side effects of Medroxyprogesterone acetate depot (≥ 1 in 100): Weight gain 2–5 kg, Amenorrhea (50% by year 1), Irregular bleeding in first 3–6 months, Headache, Decreased libido, Depressive episodes. See the Safety section for uncommon and serious reactions.
Do not administer in pregnancy.
WHO MEC 2015 category 1 from day 1 postpartum. Does not reduce milk supply. Medroxyprogesterone RID about 1%, Hale L1.
Medroxyprogesterone acetate depot is contraindicated in: Hypersensitivity; Pregnancy; Unexplained uterine bleeding; Breast cancer; Severe liver disease. Full list in the Safety section.
FDA black box: prolonged use beyond 2 years lowers BMD with possibly incomplete recovery. Use cautiously in teens and women at risk for osteoporosis.
Mifepristone, Norelgestromin + Ethinylestradiol (transdermal patch), Norethisterone, Progesterone, micronized, Red clover (Trifolium pratense), Cyproterone acetate + Ethinylestradiol, Estradiol + Nomegestrol acetate, Ethinylestradiol + Levonorgestrel