Usually, a woman with any of the conditions listed below should not use progestin-only injectables. In special circumstances, however, when other, more appropriate methods are not available or acceptable to her, a qualified provider who can carefully assess a specific woman’s condition and situation may decide that she can use progestin-only injectables. The provider needs to consider the severity of her condition and, for most conditions, whether she will have access to follow-up care.

  • Breastfeeding and less than 6 weeks since giving birth (considering the risks of another pregnancy and that the woman may have limited further access to injectables)
  • Severe high blood pressure (systolic 160 mm Hg or higher or diastolic 100 mm Hg or higher)
  • Acute blood clot in deep veins of legs or lungs
  • History of heart disease or current heart disease due to blocked or narrowed arteries (ischemic heart disease)
  • History of stroke
  • Multiple risk factors for arterial cardiovascular disease such as diabetes and high blood pressure
  • Unexplained vaginal bleeding before evaluation for possible serious underlying condition
  • Had breast cancer more than 5 years ago, and it has not returned
  • Diabetes for more than 20 years, or damage to arteries, vision, kidneys, or nervous system caused by diabetes
  • Severe cirrhosis of the liver or liver tumor
  • Systemic lupus erythematosus with positive (or unknown) antiphospholipid antibodies and not on immunosuppressive treatment, or severe thrombocytopenia


Progestin-Only Injectables for Women with HIV
  • Women who are living with HIV including those who are on antiretroviral therapy (ART) can safely use progestin-only injectables.
  • The time between injections does not need to be shortened for women on ART.
  • Urge these women to use condoms as well. Used consistently and correctly, condoms help prevent transmission of HIV and other STIs.