CHAPTER 5
Monthly Injectables

Key Points for Providers and Clients
Bleeding changes are common but not harmful. Typically, lighter monthly bleeding, fewer days of bleeding, or irregular or infrequent bleeding. Return on time. Coming back every 4 weeks is important for greatest effectiveness. Injection can be as much as 7 days early or late. Client should come back even if later.

What Are Monthly Injectables?

Monthly injectables contain 2 hormones—a progestin and an estrogen—like the natural hormones progesterone and estrogen in a woman’s body. (Combined oral contraceptives also contain these 2 types of hormones.)
Also called combined injectable contraceptives, CICs, the injection.
Information in this chapter applies to medroxyprogesterone acetate (MPA)/estradiol cypionate and to norethisterone enanthate
(NET-EN)/estradiol valerate. The information may also apply to older formulations, about which less is known.
MPA/estradiol cypionate is marketed under the trade names Ciclofem, Ciclofemina, Cyclofem, Cyclo-Provera, Feminena, Lunella, Lunelle, Novafem, and others. NET-EN/estradiol valerate is marketed under the trade names Mesigyna and Norigynon.
Work primarily by preventing the release of eggs from the ovaries (ovulation).