INJECTABLE METHOD OF FAMILY PLANNING AND CONTRACEPTIVES IN NIGERIA

INJECTABLE METHOD OF FAMILY PLANNING AND CONTRACEPTIVES IN NIGERIA

Injectable contraceptives contain one or two contraceptive hormones and provide protection from pregnancy for one, two, or three months (depending on the type) following an injection. About 61 percent of all women in Nigeria who use modern contraceptive methods choose injectable contraceptives. The most widely used injectable methods contain only a progestin (POC) Less common methods are those that contain both progestin and oestrogen Progestin-Only Injectable Contraceptives (POICs).for eay chronologicl order injectable contracetive have bee divided into;

• Progestin only Injectable Contraceptives or( POIC); The most widely used injectable method)
• Combined Injectable Contraceptives or (CIC); this method  is not commonly used  

Advantages of Injectable Contraceptives Contraceptive Benefits

Injectables as method of family planning and contraceptive have this advanteges:

• They are highly effective and safe.
• A pelvic exam is not required to initiate use.
• They contain no oestrogen, so they do not have the cardiac and blood-clotting effects, which are associated with oestrogencontaining pills and injectables.
• These are long-acting methods:35 each injection provides protection for two or three months, depending on the type.
• Confidentiality asured

Non-contraceptive Health Benefits of injectable contraceptive

• Amenorrhea, which might be benefi cial for women with (or at isk of) iron-deficiency anaemia
• Decrease in sickle cell crises
• Reduction of symptoms of endometriosis
• Protection against endometrial cancer
• Protection against uterine fi broids
• Possible protection from symptomatic pelvic inflammatory diseases
• Possible prevention of ectopic pregnancy

Side effect and limitations associated with Injectable  a a method of family planning and contraeptions

• • Return of fertility may be delayed for about four months or
• longer after discontinuation.
• • They offer no protection against STIs, including hepatitis B
• and HIV; individuals at risk for these should use condoms in
• addition to injectable contraceptives.
• • This method is provider-based, so a woman must go to a health
• care facility regularly.

Use of injectables could be associated with the following side minor effects:

– Menstrual changes, such as:

- irregular bleeding

- heavy and prolonged bleeding

- light spotting or bleeding

- amenorrhea, especially after one year of use

– Weight gain

– Headache

– Dizziness

– Mood swings

– Abdominal bloating

– Decrease in sex drive

Eligibility for Using Injectable family planning and  Contraceptives method

Injectable contraceptives are safe and appropriate for the majority of women. Other women might use them with additional monitoring or care; and a few women should not use injectable contraceptives at all, or only in very limited circumstances.

Women Who Can Use Injectables without Restrictions

Both progestin only Injectable Contraceptives( POIC) andCombined Injectable Contraceptives (COIC)   are acceptable for all women between the
ages of 18-45 with established menses who fall in the folloing categorie

• Women who had children or have never given birth (nulliparous women)
• Women who want highly effective, long-term protection against pregnancy
• Mothers who are breastfeeding (after four weeks postpartum)
• Mothers who are not breastfeeding (immediate postpartum)
• Women with fi broids, endometrial cancer, or benign breast disease
• Women who cannot remember to take the pill everyday
• Post-abortion clients
• Women with anaemia, sickle cell disease, and thyroid disease
• Women with STIs and PID
• Women with family history (first degree relatives) of DVT or PE and those that have had minor or major surgery without prolonged immobilization
• Women with gestational trophoblastic disease
•  Women with viral hepatitis (acute/fl are, carrier, or chronic) andthose with mild (compensated) cirrhosis.
• Women with obesity (i.e., BMI greater than 30 kg/m2)

Women in the following situations can use Progestin only Injectable Contraceptives (POIC), but not Combined Injectable Contraceptives or (CIC)

• Women receiving anticonvulsants (e.g., phenytoin, carbamazepine, barbiturates, primidone, topiramate, oxcarbazepine, or lamotrigine)
• Women with HIV and AIDS and who are receiving treatment with NRTIs, NNRTIs, and Ritonavir-boosted protease inhibitors.
• Women receiving Rifampicin and Rifabutin for TB.

Women Who Can Use Progestin Only Injectables Contraceptive (POIC) with Extra Precautions

Clinicians may provide you with the injectable contraceptives to and then put you on follow

• Women who are younger than 18 or older than 45.
• Decreased bone density
• Heavy or irregular vaginal bleeding patterns after evaluating an underlying condition, such as cervical cancer,after method initiation.
• CIN or cervical cancer awaiting treatment. The treatment might render the woman sterile.
• Migraine without aura.
• History of DVT or PE, current DVT or PE and established on anticoagulant therapy, known thrombogenic mutations and hyperlipidaemias, or major surgery with prolonged immobilization.
• SLE with negative antiphospholipid antibodies, on immunosuppressive treatment and those without severe thrombocytopenia. If a woman has positive or unknown antiphospholipid antibodies, she would not be injected
• History of hypertension, adequately controlled BP, or BP between 140/90 and 159/99.
• Gall bladder disease, symptomatic or asymptomatic.
• Uncomplicated diabetes.
• Focal nodular hyperplasia (benign liver tumour).

Women Who Should Not Use Progestin-only Injectable Contraceptives

• Breastfeeding women less than four weeks postpartum 3
• Women with severe liver cirrhosis 3
• Women with benign (Hepatocellular adenoma) or malignant liver tumour (hepatoma)
• Women with unexplained abnormal vaginal bleeding before evaluation
• Women with multiple risk factors for arterial cardiovascular disease (various combinations of older age, smoking, diabetes, and hypertension)
• Women with a current case of or history of ischaemic heart disease
• Women with diabetes mellitus complicated by vascular disease
• Women whose blood pressure is equal to or higher than 160/100, and women with vascular disease
• Women with a history of  stroke
• Women with a current diagnosis or history of breast cancer 4

When to Start injectables family planning and contraceptive methods

 At any time you are  certain are not pregnant.

• If you starts using an injectable family planning and contraceptive within seven days after the start of your monthly bleeding, you will not need a back-up method.

• If you starts using an injectable more than seven days after her

monthly bleeding, you should use a backup method for the fi rst

seven days after injection.

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