What is a contraceptive injection?
The contraceptive injection, sometimes called the contraceptive depot, is an injection of long-acting medicine in liquid form that protects against pregnancy for a number of weeks. The ones usually used in Malta are Depo-Provera and Sayana Press and each injection lasts for 13 weeks. This means an injection needs to be taken every 13 weeks to remain protected against pregnancy.
The contraceptive injection is different from the implant because it does not contain a plastic rod that stays under your skin. The injection is purely liquid.
How does the contraceptive injection work and how effective is it?
The contraceptive injections contain a hormone called Medroxyprogesterone, which is a type of progestogen that prevents ovulation and therefore prevents pregnancy. Each dose contains enough medicine to last for 13 weeks, and therefore you do not have to remember to take pills or use a condom during this time. The injection is over 99% effective at preventing pregnancy.
Side effects may include headaches, mood swings, and breast tenderness. After having the injection periods may stop or become irregular. The injection does not contain oestrogen, and is therefore suitable for women who cannot take oestrogen.
Although the efficacy of Depo-Provera and Sayana Press starts to wane after 13 weeks, in some cases fertility may take up to a year to return. If this is an issue for you, consider using other forms of contraception.
How is a contraceptive injection given?
The contraceptive injection is given as an intramuscular or subcutaneous injection, usually in the upper arm, or lower abdomen, or thigh, or gluteal region (the bottom).
If the first injection is given within 5 days of the start of your period, you will be protected against pregnancy straight away. If it is given at any other time of the menstrual cycle, it can take up to 7 days to start working and you should use condoms during this time.
After 13 weeks, you should have another dose of injection to continue to remain protected against pregnancy.
How is it removed?
Unlike the implant, the injection is in liquid form and therefore cannot be removed after it is inserted. If you experience side effects or you would like to become fertile again, you will have to wait for the injection to wear off.
How much does it cost and how do I get the contraceptive injection in Malta?
In Malta the Depo-Provera, which is an injection that lasts for 13 weeks, costs around EUR 50. This injection needs to be administered by a doctor, so you will also need to pay doctor's fees and clinic fees.
Sayana Press is a similar injection to Depo-Provera, and it is also available in Malta. It lasts for 13 weeks and also costs around EUR 50. The main advantage of Sayana Press over Depo-Provera is that you can inject Sayana Press yourself at home. You will still need to see a doctor to get a prescription for Sayana Press and be shown how to use it.
Depo-Provera and Sayana Press contain the same active ingredient: a hormone called Medroxyprogesterone, and therefore they tend to have the same side effects. Combined contraceptive injections with both an oestrogen and a progestogen are not available in Malta.
You can have the contraceptive injection at private gynaecology clinics, such as St James Hospital. Not every gynaecologist does contraceptive injections, so be sure to check with them before you book your appointment. Unfortunately, the contraceptive injection is not available on the public health service, and has to be paid for privately.