TW: Mentions of mental health conditions and weight gain and loss issues. Mention of abortion.
“Contraception and Me” speaks to real people about their contraception experiences and gives you their honest answers. Each month, we’ll look at a different kind of contraception. This month, we’re looking at the contraceptive injection.
—
The contraceptive injection works in largely the same way as the implant and the progesterone only pill: it contains synthetic progesterone. This helps avoid pregnancy in two ways: it thickens cervical mucus so that sperm would have a harder time reaching the egg, stops ovulation, and thins the uterus lining so that a fertilised egg cannot embed. The injection is given by a nurse into a muscle – most commonly the buttock muscle because of the large surface area, but the arm is also used. The most commonly used contraceptive injection in the UK is Depo-Provera and it lasts for 12 weeks; although you can also get Sayana Press (which is done subcutaneously, not into the muscle) and Noristerat which last 13 and 8 weeks respectively.
Side effects include weight gain, headaches, and breast tenderness; similar to other methods that use synthetic progesterone. Your periods may reduce or stop altogether. It is more than 99% effective at preventing pregnancy. It offers no protection against STIs. Should you choose to stop having the contraceptive injection to become pregnant, it can take a while for fertility to return to normal – speak to your doctor if this is a concern for you.
Depo-Provera has also been known to have a link to osteoporosis, because of its effects on the oestrogen in your body and the effects this can have on bone density – similar to how the risk of osteoporosis increases post-menopause. Make sure you discuss these risks with your doctor if you are concerned.
—
Eight respondents for the contraceptive injection.
What made you choose this type of contraception over other types?
CP: I am already on lots of tablets for other conditions and/or disabilities, and didn’t want to add another tablet to the mix, but wanted a back up to condoms. The implant or coil seemed a bit too invasive and I actually really don’t mind injections.
SLD: Couldn’t remember to keep taking the pill.
JLS: I have chronic uterine pain - I was on the pill in various forms for 12 years and I was still in constant pain. I was offered the patch, injection, or IUD. The IUD freaks me out and the patch had sh*t long term side effects so I decided on the injection. As a bonus it usually stops menstruation.
SP: I’d heard it stopped your periods and I was getting hellish pains every month the older I got.
LN: The nurse said it’d be a good idea. (At the time, I assumed that was because it was probably cheaper for the NHS than the pill).
JA: I struggle with pills; as I’m in a long term het relationship I needed a long term contraception.
SH: I was having negative side effects to the contraceptive pill: nausea and sickness which was causing it to be ineffective. Then later, after not being on contraception for about 3 years, in honesty I felt an urgency to be on contraception following an unplanned pregnancy and just went with what I knew. I very briefly looked in to the coil but the sexual health clinic in my local town had suffered drastic cuts so the consultation was brief and I was unable to ask all the questions I would have liked too.
AJ: I’m not very good at swallowing pills anyway, so having to do it every day proved difficult. I needed an option that made me feel protected against pregnancy for those unplanned nights where you don’t have a condom. Condoms also make me feel a bit awkward and uncomfortable and don’t make sex particularly enjoyable for me (or are yet to make it enjoyable for me. Maybe lessons on condom sizes should be part of sex ed? Editors Note: Watch this space). Plus, my best friend started getting the injection at 17, and she had a great experience!
Arm or ass? And did you get the choice?
7 out of 8 of the respondents had their injection in the muscle surrounding their bum, and none were offered the alternative to what they got.
CP: Until I read this question I genuinely didn’t know you could have it in your arm! To be honest I really wasn’t fazed by it being done in my ass. In fact, as they said the needle was slightly thicker than normal injection needles having it somewhere with more fat seems like a good idea… I probably would have chosen ass anyway.
SP: The nurse said: “We don’t do it [in the arm] anymore; it gets the depo to the source quicker, and your bum’s more fleshy than your arm.”
AJ: Well actually it was more in my hip, lovehandles area
Did you experience any side effects?
CP: The first week or so was great, and I couldn’t even tell I had anything done however, after a few weeks I got a period. Completely normal as your body is getting used to the hormones and it eventually calms down, but a few months later the contraceptive aspect of the injection had gone, but the period remained. Doctors suggested another injection may stop the period, but by this time it was beginning to affect my mental health. I had anxiety about the idea of putting more of the same stuff that had caused this period inside me, in order to stop it. The end result is that this one period lasted two years (with no breaks), caused a severe mental breakdown. My mental health was shot, I was spending £100’s on period products, and I went to my local GP sobbing about and begging for a cure. I ended up taking a hormone pill which stops your period (you can get it for holidays etc.) but took it over several months with a one week break, in order to train by body back to having a normal cycle again.
SLD: None that I know of.
JLS: At first I did have the weight gain side effect because it messes with your hunger and I just was constantly hungry; after a few weeks that went away. It has also stopped my period almost completely. (I’ve had 1 period in the last three injection periods).
SP: My periods stopped, totally. No spotting, no pains, nothing. Weight and skin stayed the same, migraines didn’t get better or worse. So I just stopped menstruating. In fact, I was on my period the day I got the first injection and I stopped bleeding within 24 hours.
LN: The main side effect I experienced was that it stopped my periods.
JA: I had to stop having the injection after the very first term of it because of the side effects. I struggle with depression anyway, but on depo I went crazy and got manically depressed, which affected my studies and my personal relationships pretty badly!
SH: My only obvious side effect was having no periods, with the exception of a 6 month period following a bereavement. It was suggested that the stress relating the loss had caused me to bleed continuously. Once I had stopped receiving the injection my periods did not return back to a normal (for me) schedule for minimum of 2 years.
AJ: At first my periods went spotty, but they did eventually stop. But over the time I was on the injection, I ballooned. I am aware there were other contributing factors, but I put on an alarming amount of weight. Looking back, I think it also affected my anxiety and contributed to my very low moments. I got my last injection and then moved about a month after. I joined a gym and started going every day, but I didn’t see any change in my weight (much to my disappointment) until the injection had worn off and my periods started again.
Was it effective?
Across all eight respondents, there was one reported pregnancy.
LN: I got pregnant on it and, due to my lack of periods, I didn’t realise for 5 1/2 months that I was pregnant. I had only put on 3 pounds, you see, and I thought it was Christmas weight. By the time I found out I was pregnant and how far along I was, it was too late for an abortion. I don’t know if I would definitely have had one anyway, but I do know that I didn’t have the choice.
Would you use this method again?
CP: No. I would never use this again. Ever. The experience has made periods and contraception become a huge trigger for my anxiety and has had long lasting affects I’ve had to continue to treat through CBT. I’ve had similar experiences (a really long period) with many other contraceptives since, but these experiences caused me to give each one much less time to “settle”, perhaps meaning it took me longer to find a set up for me that worked.
SLD: Yes
JLS: I’d def use it again. It’s super easy and I don’t have to worry about taking my pill or anything. I’m not a fan of needles but even I can see that one jab every three months is nbd (no big deal).
LN: No. For obvious reasons.
JA: No, I wouldn’t go on it again as I think I’ve found I don’t get on with hormonal contraception!
SH: I probably would not use this method again, as I have researched other forms of contraception further I find this to be commonly regarded as fairly aggressive. I am also at a time in my life that I would like consider having a family but could not plan so far in advance to choose to come off contraception and allow a two year time period before being able to potentially conceive.
AJ: When I moved house and away from my doctor, I came off it and let it fully wear off (which took about 6 months from my last injection) and let my periods start again before looking at other options. I would not go back on the injection again.
Anything else you would like to add?
SLD: (Who contributed to our implant article too) I’m not sure if the injection was better at controlling my periods vs. the implant that doesn’t work now, but it was so long ago!
SP: I was on it for 2 years, and stopped on my doctor’s advice, due to risk of osteoporosis. I went back on it at the first opportunity. This time I was “allowed” to stay on it for 4 years. Then my doctor (female) refused to let me stay on it. I said, I knew the risks, she still said no. This was roughly 2 years ago and I haven’t bled since, which is great. Not bleeding for years on end might be an issue for someone who doesn’t want kids NOW, but might want them in the future – I didn’t want them.
SH: I am so grateful to have been offered choices and safe environments to practice sex safety.
AJ: I didn’t realise that the options were all hormonal, and I didn’t understand how much of an effect that has on your body AND your mind. I don’t think anyone really realises, and I certainly didn’t realise it for a long time.
—
Next month, we’ll be looking at the IUS and the IUD, otherwise known as the coil.
—
Image by Wikimedia Commons
