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Was my Depo injection as effective since it was given in the hip? #802/12

The last time I went in for my Depo shot this particular nurse acted as it was common practice for her to give the Depo IM shot in the hip as opposed to the buttock where I have usually gotten my shot.  She claimed it helped with absorption, because she said it did not interfere with fatty tissue.  I let her give me the injection in my hip, but I later started wondering if it was still effective there.

 

Thanks!


My suggestion:

           

I imagine that your injection is working where it was given.  I will ask others for their opinions.

 

Here are the recommendations from the 19th and 20th editions of Contraceptive Technology:

 

PROVIDING DMPA

DMPA is provided in either 1 cc vials or prefilled syringes containing 150 mg. The label states a 2-year shelf-life. Using a sterile needle and syringe, inject the DMPA deeply into the deltoid or the gluteus maximums muscle. Injections into the deltoid are less embarrassing but may be slightly more painful. The 21- to 23-gauge needle should be 2.5 to 4 cm long. Immediately after injection do not massage the area over the injection, because it could lower the effectiveness of DMPA. DMPA-SC is available in prefilled, single-use syringes. Subcutaneous DMPA injections can be given in the anterior thigh or abdominal wall.

 

If a DMPA injection is given within 5 to 7 days of a normal last menstrual period, no backup contraception is needed. The WHO states that DMPA can be given at any time in a menstrual cycle if the woman can be reasonably certain that she is not pregnant. If DMPA is given later than the seventh day in the menstrual cycle, it is important that women use backup contraception for 7 days and receive a follow-up pregnancy test several weeks later to diagnose pregnancy in a timely fashion. A recent study of immediate initiation of DMPA among 149 women who presented on cycle day 8 or later, found that 47% of women continued to a second dose of DMPA, 92% returned for their follow up pregnancy test (half required many reminders) and 3 women were pregnant (2%).


In terms of effectiveness, Dr. Andrew Kaunitz, was her Depo injection into her hip a problem?  If so, should I recommend that her next injection be earlier than 3 months?


From Dr. Andrew Kaunitz: “My perspective is that as long as injection is administered DEEP IM, it will be effective.  Keep in mind that the standard IM dose of 150 mg is more than enough to provide effective contraception.”


 

To learn more about the advantages and disadvantages of Depo-Provera injections, go to our website: www.managingcontraception.com and click on Choices.  You can also order this wonderful new educational book from our website or by calling 404-875-5001.  Do you have your copy yet?



Andrew M. Kaunitz MD

Professor and Associate Chairman

Department of Obstetrics and Gynecology

University of Florida College of Medicine-Jacksonville



Key Words:  Depo-Provera injection, hip, buttock, absorption, interfere, fatty tissue, effective, recommendations, Contraceptive Technology

 

Reference:

Bartz D, Goldberg AB. Injectable contraceptives IN Hatcher RA, Trussell J, Nelson AL, Cates Jr. W, Kowal D, Policar M. et al Contraceptive Technology 20th edition, page 223: Ardent Media Inc. 2012

 

Goldberg AB, Grimes DA. Injectable contraceptives IN Hatcher RA, Trussell J, Nelson AL, Cates Jr. W, Stewart F, Kowal D. et al Contraceptive Technology 19th edition, pages 168-169: Ardent Media Inc. 2008
Posted 8-11-2012, Updated 8-31-2012

 

Robert A. Hatcher MD, MPH
Emeritus Professor of Gynecology and Obstetrics
Emory University School of Medicine
Atlanta, GA
---2012-09-1


Contraceptive Technology 20th Edition & Managing Contraception
  


Managing Contraception for Your Pocket 2013-2014
  


Choices, English
  

The directors and owners of this website and any publications and information concerning health matters offered here advise a person with a particular problem to consult a primary-care clinician or a specialist in obstetrics, gynecology, or urology (depending on the problem or the contraceptive) as well as the product package insert and other references before diagnosing, managing, or treating the problem.
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