The Coming-of-Age of Subcutaneous Injectable Contraception

Figures & Tables

TABLE.

A Comparison Between DMPA-SC and DMPA-IM Injectables

Characteristic	DMPA-SC	DMPA-IM
Formulation	104 mg/0.65 mL of DMPA in the Uniject injection system; all-in-one Uniject system simplifies procurement and logistics	150 mg/mL of DMPA, administered by intramuscular injection, available in vials or prefilled syringes
Needle	3/8” needle; 23 gauge ultra-thin	1” needle; 22 gauge with a 21–23 gauge range option
Administration	Where permitted, can be administered by CHWs, pharmacists, or by the woman herself	Typically administered by a provider, but can be administered by CHWs and pharmacists where permitted
Shelf life	3 years	5 years
Efficacy	99% contraceptive efficacy
Safety	Similar safety profile
Duration and mechanism of action	Provides 3 months of contraceptive protection per dose by preventing ovulation and thickening cervical mucus
Safety during breastfeeding	Safe for breastfeeding mothers at 6 weeks postpartum
Health benefits	Reduces the risk of endometrial and ovarian cancer Protects from uterine fibroids, endometrial cancer, ectopic pregnancy, and symptomatic pelvic inflammatory disease May reduce sickle cell crises in some women with sickle cell anemia Prevents seizures in some women with epilepsy Prevents iron deficiency anemia in some women
Side effects	May cause headaches, bleeding irregularities, weight gain, injection-site reactions
Protection against HIV or other STIs	Does not protect against HIV or other STIs

Abbreviations: CHW, community health worker; DMPA, depot medroxyprogesterone acetate; DMPA-IM, intramuscular DMPA; DMPA-SC, subcutaneous DMPA; STI, sexually transmitted infection.
Source: Spieler (2010)¹ and Family Health International (2010).⁹