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Contraception - Management
What follow-up arrangement should I consider for a woman using a progestogen-only injectable?
- For women using norethisterone enantate, arrange for the second injection to be given in 8 weeks.
- For women using depot medroxyprogesterone acetate, arrange repeat injections at 12-week intervals:
- There is a two-week 'window of safety' if the repeat injection is late.
- At the follow-up visit:
- Check the woman's knowledge of what to do if is she is late.
- Review for any new risk factors — see the UK Medical Eligibility Criteria.
- Address any issues or problems she might have. The most common problems are:
- Weight gain.
- Irregular menstrual bleeding: see Advice on menstrual irregularity.
- If problems arise, change to another method (if this is what she wants or needs), or repeat the injection, or change to the other type of injectable.
Basis for recommendation
- These recommendations are based on expert opinion [Guillebaud, 2007] and informed by guidelines from the Faculty of Sexual and Reproductive Healthcare (FSRH), formerly the Faculty of Family Planning and Reproductive Healthcare (FFPRHC) [FFPRHC, 2002; FFPRHC, 2006a].
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