Chapter 4

Who Can and Cannot Use Progestin-Only Injectables

Safe and Suitable for Nearly All Women

Nearly all women can use progestin-only injectables safely and effectively, including women who:

  • Have had children or have not had children
  • Are married or are not married
  • Are of any age, including adolescents and women over 40 years old
  • Have just had an abortion or miscarriage
  • Smoke cigarettes, regardless of age or the number of cigarettes smoked
  • Are breastfeeding, starting as soon as 6 weeks after childbirth
  • Are living with HIV, whether or not they are on antiretroviral therapy (see Progestin-Only Injectables for Women Living With HIV)
  • Are at high risk of HIV, or other STIs.

Avoid Unnecessary Procedures

(see Importance of Selected Procedures in Chapter 26 – Family Planning Provision)

Women can begin using progestin-only injectables:

  • Without a pelvic examination
  • Without any blood tests or other routine laboratory tests
  • Without cervical cancer screening
  • Without a breast examination
  • Without a pregnancy test. A woman can begin using a progestin-only injectable at any time, even when she is not having monthly bleeding at the time, if it is reasonably certain she is not pregnant (see Pregnancy Checklist).
Blood pressure measurement is desirable before starting a hormonal method. However, where the risks of pregnancy are high and few methods are available, a woman should not be denied a hormonal method simply because her blood pressure cannot be measured. If possible, she can have her blood pressure measured later, at a time and place convenient for her.