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Monthly contraceptive injection: Expanding female patients' options

Shulman, Lee P.  Female Patient, OB/GYN ed.; Chatham Vol. 25, Iss. 11,  (Nov 2000): 14.

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A long-awaited, oncemonthly hormone injection is now available for females who seek a birth-control method that is highly effective, safe, and reversible.

Despite the availability of numerous types of contraceptives, approximately 50% of pregnancies in the United States (roughly 3 million per year) are unplanned.' These pregnancies, which result in considerable personal, social, and economic stress, are by no means inevitable. They are avoidable-if safe and effective contraception is used, and if the chosen contraceptive method is used correctly. As many women who require contraception wish to retain their fertility, these contraceptive methods should also be reversible.

Correct and consistent use of a contraceptive method depends on many different factors. These include women's satisfaction with their clinician, absence of specific side effects (which vary among individuals), availability of educational resources concerning contraception, and establishment of a contraceptive "ritual" or routine. Successful contraceptive use is also dependent on choosing the "right" method--one that suits each user's needs and lifestyle. Indeed, the particular contraceptive option that is chosen is the most important factor in determining whether contraception is used consistently and correctly. To this end, development of new contraceptive options provides more choices that may be accepted by women who are unwilling or unable to use existing methods.

In the United States, oral contraceptives (OCs) are the most commonly used method of reversible contraception. However, only 22% of US women use OCs.2 Among women who begin using a reversible method of contraception, 31% discontinue it because of a methodrelated problem within the first 6 months, and 44% stop use within 12 months.3,4 These statistics suggest that method-related problems, such as the need to take a pill every day, contribute to high discontinuation rates.

Contraceptive options available to US women have just expanded with approval by the Food and Drug Administration (FDA) of...