CONTENTS
Published with this issue: HIGHLIGHTSPublished by the Population Information Program, Center for Communication Programs, The Johns Hopkins School of Public Health, 111 Market Place, Suite 310, Baltimore, Maryland 21202-4012, USA
|
S
ide Effects and Complications Disruption of regular menstrual bleeding and amenorrhea are the most common side effects of injectables and the main reasons that women stop using them. Also, most women report weight gain. Far fewer women report a variety of other side effects, for example, headaches, dizziness, abdominal discomfort, acne, and moodiness. These side effects are bothersome for some women, but they are generally not dangerous. Some of these less common side effects are plausible reactions to hormones, while others occur at rates typical of the general population and cannot be clearly attributed to injectables. Because bleeding changes and weight gain are so common, during counseling all women who choose injectables should be told of these likely changes. Program managers need to decide what other side effects to mention based in part on the side effects most often reported by clients. These decisions should be made with the goal of helping clients to make a fully informed choice and to use the method effectively and confidently (see Chapter 7.2 Bleeding Changes of the Counseling Issues chapter). Researchers have investigated whether use of injectables might increase the risk of certain serious conditions. In general, studies of the cardiovascular system, carbohydrate metabolism, liver function, and lactation have been reassuring (see Table 4). Some recommended restrictions on use of DMPA and NET EN, however, are based on their effect on cholesterol metabolism (see Cholesterol metabolism in Chapter 4.2). Conflicting findings on bone density and the outcome of pregnancy are being debated (see Chapter 4.3 Bone Density and Chapter 4.4 Fetal and Child Development). |