Injectable contraceptions gaining popularity in India: Advantages, side effects of DMPA injections

Antara — the injectable contraception prescribed to women under the National Family Planning Programme of the Ministry of Health and Family Welfare (MoHFW) — is gaining popularity among women in parts of India, according to recent reports. This method of contraception was introduced in India in different phases since 1993, and despite the COVID-19 pandemic, reports suggest that women in Rajasthan particularly are opting for it. The health ministry recently revealed that women in the state went from using 88,000 injectable contraceptives in 2018-19 to 99,496 in 2019-20. Officials working on the project have revealed that they were able to achieve 90 percent of their target of injectable contraceptives in spite of the pandemic. So, what is it about this particular type of contraception that’s leading to its acceptance and adoption by women in India? Here are the five most frequently asked questions about injectable contraception and their use in India. 1. What is injectable contraception? According to the National Health Mission (NHM), an injectable contraceptive is an intramuscular hormonal contraceptive method for women that prevents pregnancy. A single dose of this contraceptive provides three months of protection, so women need to take four injections a year at equal intervals to avoid pregnancy. The Central government introduced injectable contraceptives to provide women with better family planning options, especially where the timespan between two pregnancies is concerning. 2. How effective is injectable contraception? The injectable contraception called Antara consists of depot-medroxy progesterone acetate (DMPA) according to the All India Institutes of Medical Sciences (AIIMS). An introduction through the buttocks or upper arms, DMPA prevents monthly ovulation, thickens the cervical mucus (therefore blocking sperm) and thins the endometrium, which makes implantation of an egg difficult. Experts believe this form of contraception is more than 99 percent effective in avoiding pregnancies if doses are administered as per schedule. This makes it as effective as tubal ligation, and much more effective than diaphragms, condoms and contraceptive pills. 3. When can you start taking injectable contraception? According to AIIMS and the NHM, injectable contraceptives should be taken only after proper screenings are done by a gynaecologist. This primary step is taken mostly to ensure that the woman is not already pregnant. Once this is done, you can take the first dose of injectable contraceptive:

• Within the first five days after the beginning of regular menstruation period
• After six weeks of delivering your baby (which is also when it’s safe to resume sexual activity)
• Immediately after abortion
• Immediately after discontinuing other forms of contraceptives

4. What are the advantages of using injectable contraception? AIIMS insists that injectable contraception is “effective, long-acting and reversible”, and helps maintain privacy. It doesn’t require you to take a pill regularly, doesn’t lead to estrogen-related side-effects like dyslipidemia or increased risk of heart attack, and doesn’t affect the quality or quantity of breast milk (if you’re a breastfeeding mother). Injectable contraceptives may also help prevent issues like ectopic pregnancy, endometrial cancer, uterine fibroids, ovarian cancer, iron-deficiency anaemia and may reduce seizures in women with epilepsy. 5. Are there any side-effects of using injectable contraception? The side-effects of injectable contraception may include changes in menstrual bleeding patterns, irregular spotting or bleeding, scanty periods, breast tenderness, weight gain, acne and depression. This method of contraception does not provide protection against sexually transmitted infections (STIs). Return of fertility can take up to nine months after the last dose of injection, which is much longer than in other modes of contraception. For more information, read our article on Family planning methods and types. Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.