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Progestogen-only injectables risks & benefits

This table summarises the risks and benefits of injectable contraceptives with their respective evidence gradings as listed by FSRH. It is important to understand that this is a summary and there may be individual patient factors that could influence the choice and use of these contraceptives.

AspectDescription and EvidenceGrading of Recommendations
Benefits

EfficacyThe failure rate is around 0.2% with correct use and about 6% with typical use.Evidence-based on randomised controlled trials
Menstrual BenefitsAmenorrhoea or reduced bleeding is common, benefiting those with menstrual problems. DMPA may also reduce pain linked to endometriosis.Evidence-based on other robust experimental or observational studies
Cancer ProtectionDMPA isn't linked with a heightened risk of ovarian or endometrial cancer and may offer protection.Good Practice Point
Sickle Cell DiseaseIt's a contraceptive option for women with sickle cell disease and may diminish the severity of sickle crisis pain.Evidence is limited but relies on expert opinion
Risks

Bone Mineral Density (BMD)Use is connected with a small loss in BMD, which is typically regained after stopping.Evidence-based on randomised controlled trials
Breast Cancer RiskThere's a potential link between hormonal contraception (including progestogen-only injectables) and a slight increase in breast cancer...

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