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Injectable Contraceptives
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Section 1
Section 2

- Progestin-Only
- Objectives
- Activity
- Advantages
- Advantages
- Benefits
- Activity
- Disadvantages
- Activity
- Side Effects
> Menstrual
- Counseling
- Treatment
- Treatment
- Amenorrhea
- Weight Gain
- Fertility
- Activity
- Safety
- Breast Cancer
- Cervical
- Endometrial
- Other Cancers
- Fetal Exposure
- Infants
- Activity
- Bone Density
- WHO Criteria
- WHO Criteria
- WHO Criteria
- Not Pregnant
- When to Begin
- Schedule

Section 3
Section 4
Section 5


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Section 2 - Progestin-Only Injectables: DMPA

DMPA: Menstrual Changes

DMPA: Menstrual Changes graph

Slide 14

Most women who use DMPA experience menstrual changes. Some have prolonged or heavy bleeding, others have irregular bleeding and spotting throughout the cycle, and many eventually become amenorrheic. This slide shows the typical pattern of menstrual changes over the first two years of DMPA use.

After the first DMPA injection, over 40% of users experience prolonged or irregular bleeding. Following subsequent injections, these bleeding changes become less common, and after the first year of DMPA use, they are relatively uncommon.

In contrast, infrequent bleeding and amenorrhea become more common as the duration of DMPA use increases. Amenorrhea is a normal response to the progestin in DMPA, which causes the endometrium to become thin, resulting in little or no menstrual bleeding. Nearly half of women are amenorrheic after one year of DMPA use, and about 80% are amenorrheic after two years of use. After women stop using DMPA, normal menses return.



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