World Health Organization ; World Health Organization Offeset Publication No. 65: Injectable Hormonal Contraceptives ; Technical and Safety Aspects

By World Health Organization

Book Id: WPLBN0000060092
Format Type: PDF eBook:
File Size: 1.25 MB
Reproduction Date: 2005

Title:	World Health Organization ; World Health Organization Offeset Publication No. 65: Injectable Hormonal Contraceptives ; Technical and Safety Aspects
Author:	World Health Organization
Volume:
Language:	English
Subject:	Health., Public health, Wellness programs
Collections:	Medical Library Collection, World Health Collection
Historic Publication Date:
Publisher:	World Health Organization


Citation APA MLA Chicago Health Organization, B. W. (n.d.). World Health Organization ; World Health Organization Offeset Publication No. 65. Retrieved from http://gutenberg.cc/

Description
Medical Reference Publication

Excerpt
PREFACE This publication has been compiled for those who are involved in the development and management of family planning services as part of health care programmes. It deals with certain injectable hormones which are highly effective contraceptives and have an important place in many national family planning or family health programmes. The aim of this booklet is to present the problems, advantages and disadvantages associated with the use by women of injectable hormonal contraceptives and to provide information to health care administrators and planners who are interested in introducing this method of contraception into a health care programme. The views summarized here are based on a critical review of many clinical and basic science studies and field trials. A most important source of this information has been the WHO Special Programme of Research, Development, and Research raining in Human Reproduction (in particular, its Task Force on Long-Acting Agents for Fertility ~egulation), which has coordinated a large number of studies from developing countries. In fact much of the information contained in Sections 2 to 5 of this booklet has been taken from a report prepared under the Special Programme (1). This report is the result of a meeting held by WHO-^^ October 1981, in which both animal and human data were extensively reviewed by members of the Special Programme's Toxicology Review Panel, representatives of the drug regulatory agencies of India, Mexico, Sweden, Thailand, United Kingdom and the USA, representatives from the pharmaceutical industry manufacturing these products, and expert scientists working in this field.

Table of Contents
CONTENTS Page Preface . . . . . . . . . . . . . . . . . . . . . . . 5 Acknowledgements . . . . . . . . . . . . . . . . . . . 7 1 . Introduction . . . . . . . . . . . . . . . . . . 9 2 . Background and description of injectable hormones available as contraceptives . . . . . 9 3 . Pharmacology . . . . . . . . . . . . . . . . . . 15 4. use-effectiveness . . . . . . . . . . . . . . . . 16 5 . Side-effects and possible long-term sequelae . . 17 5.1 Bleeding ~roblems . . . . . . . . . . . . . 17 5.2 Metabolic effects . . . . . . . . . . . . . 18 5.3 Possible carcinogenicity . . . . . . . . . 20 5.4 Ekturn of fertility . . . . . . . . . . . . 21 5.5 Effects on progeny . . . . . . . . . . . . . 22 5.5.1 In utero exposure to injectable hormones . . . . . . . . . . . . . . 22 5.5.2 Exposure of infants via breast milk . . . . . . . . . . . . . . . . 22 5.6 Other side-effects . . . . . . . . . . . . . 23 6 . Clinical management . . . . . . . . . . . . . . . 23 6.1 Contraindications to the use of DMPA . . . . 24 6.2 Contraindications to the use of NET-EN . . . 24 6.3 Special problems that require medical assistance . . . . . . . . . . . . . . . . . 24 6.4 History and physical examination . . . . . . 25 6.5 Selection of the type of injectable progestogen . . . . . . . . . . . . . . . . 26 6.6 Duration of use . . . . . . . . . . . . . . 27 6.7 Indications for discontinuation . . . . . . 27 6.8 Administration of DMPA and NET-EN and follow-up . . . . . . . . . . . . . . . . . 28 6.9 Treatment of bleeding problems . . . . . . . 28 7 . Counselling . . . . . . . . . . . . . . . . . . . 30 7.1 Package insert for women on injectable contraceptives: an example . . . . . . . . . 31