The implant and injectable methods of contraception

Depoprovera (Progestogen injection- medroxyprogesterone acetate)

  • Injection to be within 5 days of last menstrual period
  • Lasts 12 weeks per injection


  • Not concordant with the COC pill or POP
  • If there are contraindications to oestrogens
  • Sickle cell disease
  • If the patient requires long-term progestogens
  • If the patient is on enzyme inducing drugs e.g. anti-epileptics
  • If the patient is at risk of/is being treated for endometriosis


  • see also POP
  • short term contraception
  • puerperium (6 weeks following childbirth)
  • Severe obesity
  • Dislike of amenorrhea (35% at one year)
  • Uncontrolled hypertension
  • Long term in those at high risk of osteoporosis
    • In adolescents, it may be used after other methods have been considered unsuitable/unacceptable
    • Re-evaluation (in all women) should happen every 2 years to assess risk/benefit ratio (including a DEXA scan if necessary)
    • Alternative should be sought for those at risk (lifestyle or medical)

Implanon/Nexplanon (the implant)- Etonogestrel (Nexplanon also has barium so is radio-opaque)

  • almost 100% effective
  • lasts 3 years
  • not suitable for those taking enzyme inducing drugs (e.g. antiepileptics)
  • Consider changing earlier if problematic bleeding towards end
  • Inserted between day 1 and 5 of the cycle for immediate effect
  • Side effects include irregular bleeding; skin changes; headaches; weight gain; loss of libido; (amenorrhea)

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