Three-month syringe

introduction

The three-month injection is a method of contraception in which the gynecologist injects a hormone-containing preparation into the muscles of the buttocks or upper arm every three months. This continuously releases a hormone for the period that suppresses ovulation, thus preventing pregnancy. The three-month syringe is therefore an alternative to hormonal contraception with the contraceptive pill or the hormone IUD. The method is comparatively reliable and unwanted pregnancy rarely occurs. In addition, you do not have to regularly think about taking tablets and vomiting or diarrhea does not affect the effect.

However, the preparation cannot simply be discontinued but must first be broken down by the body. Even after that, it can take years before a normal cycle resumes and pregnancy is possible. In addition, pronounced side effects are possible due to the high dose of hormones. The three-month injection is therefore suitable as a method of contraception for women who cannot tolerate other contraceptive methods or who cannot cope with them. Family planning should be completed if possible. The application should not exceed a period of two years.

Indications

The three-month syringe is not a first-choice contraceptive method, but should only be considered if other methods are not tolerated or the woman cannot cope with them. In addition, should if possible no desire to have children in the future consist. According to the manufacturer, the three-month injection should also only for women with a normal cycle be used. According to a recommendation by the German Society for Gynecology and Obstetrics, this method of contraception should only be used in "mature women who have completed family planning".
There is also an indication for a chronic gastrointestinal diseaseif hormone pills cannot be tolerated due to this. The method is also suitable for women who cannot reliably think about taking the pill every day or unable to keep regular intake times, for example when working shifts. Since the three-month syringe, unlike many contraceptive pills, does not contain a hormone from the group of Estrogens contains, it is also suitable for women who cannot tolerate or take such hormones.
The blood disease Sickle cell anemia also prohibits contraception with hormone tablets, so that the syringe can also be used here. Women who live in countries where the pill is not easily available can also consider contraception with the three-month injection.

Active ingredient / effect

With the three-month injection, the hormone Medroxyprogesterone acetate from the group of progestins in the woman's shoulder or gluteal muscles injected. The depot created there will be used over the coming months the active ingredient is continuously released into the bloodstream and is distributed throughout the body. Progestins, which are naturally occurring in the body. Luteal hormones (progesterone) are also produced naturally during pregnancy.
The effect takes place in several places at the same time, which prevents pregnancy. To my the progestin suppresses ovulation in the ovaries and also inhibits the build-up of the uterine lining. This can cause a fertilized Egg cell not nest. On the other hand, the Cervical mucus (Mucus in cervix) thicker, so that sperm cannot even enter the uterus. The three-month injection does not contain any other active ingredient, i.e. also no hormone from the group of estrogens.

Side effects

The three-month syringe uses a high dose of progestins affects the hormonal balance of women and various side effects can occur as a result.
Often there is one irregular period. On the one hand it can be too Spotting and intermenstrual bleeding occurs. On the other hand, the There is also no menstrual period. In addition, it often happens after the injection Tension and pain in the breasts. There can also be a loss of libido, which means that the desire for and the Decreased desire for sexual intercourse could be.
Other possible side effects of the three-month injection are Headache, abdominal pain, back pain, acne, water retention in the arms and legs (Edema) and in very rare cases liver dysfunction and Jaundice. It is also possible that the hormones cause a Depression or depressed mood to be triggered.
Furthermore, it can lead to a decrease in bone density and thus to a increased risk of osteoporosis come. The bones are less stable and can break more easily. If necessary, this effect can after medical advice counteracted by a supply of vitamin D and calcium become. Non-specific side effects that can occur are allergic reactions and bleeding after the injection of the syringe.

Hair loss

The three-month injection can lead to various side effects due to the interference with the hormonal balance. In some women, this also includes hair loss. If this symptom occurs as part of contraception with hormone injections, this is a likely cause. The ones contained in the syringe Progestins can have a similar effect on the hair roots as male sex hormones and trigger hair loss. Since it is not possible to simply stop using the hormone injection, the body must first break down the progestins. If necessary, an alternative method of contraception should be chosen to eliminate the cause of the hair loss. In the case of pronounced hair loss, the prescribing doctor should therefore be asked for advice.

Weight gain

Women who use contraception with the three-month injection often complain of weight gain. Often it is one Storage of water in the tissuewhich is caused by the hormones administered. But it can also lead to increased storage of fat, for example through increased appetite come. Weight gain caused by the three-month injection is usually limited to a few kilos. A massive increase in weight cannot be directly attributed to the contraceptive. The best way to counteract weight gain is through adequate physical exercise and a conscious diet with an adequate intake of calories

Interactions

Some drugs like Antibiotics or drugs for epilepsy can interfere with the three-month syringe. The effectiveness of the contraceptive can be impaired, so that no sure protection against pregnancy there is more. This can also be done by taking herbal products such as Johannis herbs come. Therefore, every doctor who prescribes a drug should be informed about contraception with the three-month injection. Since not all drugs from the groups mentioned lead to interactions, the practitioner can, if necessary, prescribe a specific preparation that is harmless in combination with the three-month injection.

Does the three-month injection still work despite antibiotics?

Antibiotics can affect the way the three-month injection works, so reliable protection against pregnancy can no longer be guaranteed. The antibiotics stimulate certain enzymes in the liver, which lead to an increased breakdown of the hormones and thus the active substance of the three-month injection. This is true, however only for some groups of antibiotics.
In individual cases, the prescribing doctor can explain to you whether the contraceptive is effective. In the case of an infection that requires treatment with antibiotics, there is less protection against pregnancy. Then it makes sense to use condoms as well.

Contraindications

There are some circumstances under which a three-month injection should never be given. These include Bleeding from the vagina, the cause of which is not clearly clarified, and one existing or experienced venous thrombosis. This is a blood clot that usually forms in a leg vein and can lead to a life-threatening pulmonary embolism (blockage of a lung vessel by a blood clot).

Further contraindications are severe liver diseases, cancer of the breast or uterus, certain metabolic diseases and osteoporosis (loss of bone substance). In addition, an allergy to components of the contraceptive precludes its use.

dosage

The principle of the three-month injection is that a depot of the hormone medroxyprogesterone acetate from the group of gestagens is injected into the muscles and from there is continuously released into the blood over the following three months. For this it is necessary that a proportionate high dosage is chosen, for example is significantly higher than with contraceptive pills with a similar active ingredient. Therefore, side effects of hormone treatment are more common and usually more pronounced.

costs

A three-month syringe costs around 30 € and there can be costs for placing the syringe of up to 15 €. So up to € 180 per year must be paid for the contraceptive method.

Is the three-month injection a health insurance benefit?

In most cases it is the three-month injection not a health insurance benefit and the costs must be borne entirely by yourself. A There is an exception for women under 20 years of agewhen the doctor gives the indication for the contraceptive. However, especially with young women, the three-month injection should only be considered in exceptional cases, when other methods of contraception such as the contraceptive pill or condoms are not an option.

Three-month injection and alcohol - are they compatible?

Consumption of alcohol does not affect the effects of the three-month injection and is therefore basically compatible with this method of contraception. In contrast to contraception with the birth control pill, even if the woman vomits from alcohol, the protection is not compromised. Excessive alcohol consumption should, however, be avoided as it otherwise leads to a increased liver damage can come. The hormones in the three-month injection can put a strain on the liver and alcohol directly damages the organ. Therefore, excessive alcohol consumption can lead to liver disease and loss of function of the organ in the long term, with consequences such as Jaundice, ascites and Bleeding disorders.

Alternatives to the three-month injection

There are many alternatives to the three-month injection and should be preferred in most cases. Other methods of contraception based on hormone administration are the various forms of birth control pills (classic step-by-step preparation, micropill, minipill, etc.) or contraceptive rings containing hormoneswhich are inserted into the vagina and changed monthly. In addition, a Hormone or copper coil be inserted into the uterus by the gynecologist. The copper coil prevents a fertilized egg cell from implanting and prevents pregnancy. An effective and virtually side-effect-free alternative, which, in contrast to all of the methods mentioned, also protects against sexually transmitted diseases, is the use of Condoms. Natural birth control methods as the Contraception based on the determination of body temperature or the coitus interruptusinterrupting sexual intercourse shortly before climax to avoid ejaculation in the vagina are to prevent pregnancy very insecure.

How does the three-month injection affect my period?

Three-month syringe leads to one in many women just at the beginning of use irregular period and for some too light intermenstrual bleeding or spotting. After a few months, the period in most cases weakens and can then be completely absent. How the hormones affect the period and the time in which changes occur, however, is different for every woman and cannot be generalized. If in doubt or if the bleeding is excessive, the advice of the gynecologist should be sought

Bleeding under the three month syringe

It often occurs under the three-month injection Intermenstrual bleeding and spotting, because the hormone preparation intervenes in the cycle and influences the growth and rejection of the uterine lining. If the bleeding is very heavy or if it lasts for a few days, the gynecologist should be consulted. The period can weaken after a while and even stop completely, so that some women no longer have any bleeding at all.

When does the three-month injection start working?

The three-month injection will given between the first and fifth day of the cycle and takes effect immediately. The first day of the cycle is the day on which the menstrual period begins. This means that if the injection is correct and timed, pregnancy will no longer occur. The effect is very reliable compared to other contraceptives. However, one hundred percent protection against pregnancy can never be guaranteed.

What do you have to watch out for when you stop taking the three-month injection?

If the three-month injection is stopped, it means that no further injection is given. However, the hormones injected last have to be slowly broken down by the body and this process cannot be accelerated. Therefore, if side effects cause discontinuation, they can only be treated symptomatically until hormone levels drop. This means that pain has to be treated with painkillers, for example. On the other hand, discontinuation and falling hormone levels can lead to various side effects. If the three-month injection is discontinued because a pregnancy is desired, it must be noted that it is can take up to two years for the cycle to return to normal. Accordingly, it can take a long time for the desire to have children to come true. However, this does not apply to all women, so after stopping the contraceptive method after the three months have passed since the last injection no longer protection against pregnancy consists. If you do not want to have children, you must therefore use another method - for example with condoms.

How quickly does one get pregnant after stopping the three-month injection?

The three-month syringe can, due to the high dose of hormones, upset the natural cycle so that it takes several months or even up to two yearsuntil it has normalized again and pregnancy is possible. However, that does not mean that you cannot become pregnant after stopping the three-month injection. Some women go back to a normal cycle very soon and they can get pregnant after the last three-month injection wears off. If you do not wish to have children, you should therefore use another method of contraception after stopping the injection.