Are you thinking about a family planning method? Then you probably know how many methods there are now to choose from. There are many things like birth control pills, IUDs, condoms. Among these, the most talked about and convenient method is the monthly birth control shot. So today, let's talk about one such shot, the birth control shot, which is made by combining two hormones called `Estradiol Cypionate` and `Medroxyprogesterone`. If you know exactly about this, it will be easy to choose the one that suits you best, right?
Simply put, what kind of vaccine is this?
This is a hormonal injection designed specifically for women to prevent unwanted pregnancy. Simply put, it is a monthly injection. One injection provides birth control protection for one month (about 28-30 days).
It contains two synthetic forms of two hormones that are naturally produced in the female body. These are estrogen and progestin. These two hormones work together to stop your body from ovulating, which is when an egg is released from an ovary. They also thicken the mucus in your cervix, making it harder for sperm to enter. This is how you prevent pregnancy.
Important: Although this vaccine has now been discontinued in some countries, such as the United States, similar vaccines are used in various countries, including Sri Lanka. It is best to talk to your doctor before deciding whether or not it is right for you.
What are the things you need to tell the doctor before getting vaccinated?
Before using this vaccine, it is very important that your doctor has a complete understanding of your health condition. This hormone vaccine is not compatible with some medical conditions. If you have or have had any of the conditions below, be sure to tell your doctor about it.
| Medical condition you have/had | Why is it important to tell the doctor ? |
|---|---|
| If you are a smoker | Smoking, especially if you are over 35, greatly increases the risk of blood clots and stroke when combined with hormone injections. |
| Blood vessel disease, blood clots, or stroke | This vaccine may further increase that risk. |
| Breast, cervical, uterine, ovarian, or liver cancer | Hormone-dependent cancers can become more severe. |
| Unexplained vaginal bleeding | The reason for this must be investigated first. |
| High blood pressure, heart disease, high cholesterol | These conditions can be complicated by the use of hormones. |
| Diabetes | Blood sugar levels may change. |
| Migraine, liver or kidney disease | These conditions may worsen or affect the effectiveness of the medication. |
| If you are pregnant or trying to get pregnant | This vaccine should not be given during pregnancy. |
Additionally, don't forget to mention any allergies you have to other medications, foods, or dyes.
How is this vaccine used?
This is not a shot you can give yourself at home. It is injected into your muscle (usually your buttock or arm) by a doctor or trained nurse .
- First vaccination: The first vaccination is usually given within the first 5 days of the start of your period.
- Then: You should get the next dose every month (every 28-30 days). It is very important to keep the dates accurate.
What do you do if you miss the day to get vaccinated?
It is important to get your shot on the scheduled day to maintain your birth control protection. If you miss your scheduled day, call your doctor or clinic right away to reschedule. If it has been more than 33 days (more than 4 weeks) since your last shot, you will need to take a pregnancy test before you get your next shot.
Other things that may interact with this medicine
Some other medications you are taking can reduce the effectiveness of this birth control shot. This means that if you take this shot with those medications, you may be at risk of getting pregnant. Therefore, it is very important to tell your doctor about all the medications you are taking.
Here are some examples:
- Some antibiotics - especially those used to treat tuberculosis, such as Rifampin.
- Medicines given for epilepsy (fits) - such as `Carbamazepine`, `Phenytoin`, `Topiramate`.
- Medicines for HIV infection - such as `Ritonavir`.
- Herbal supplements - especially St. John's wort.
- Antifungal medications.
This list is not exhaustive. Therefore, be sure to tell your doctor about all the medications you are taking (including vitamins, Panadol, Ayurvedic medicines, herbal products) , any supplements you are taking, and if you smoke or drink alcohol.
Things to keep in mind when getting vaccinated
- Smoking and blood clots: As we mentioned earlier, this is a very important point. If you are taking a hormone injection like this, especially if you are over 35, smoking greatly increases your risk of blood clots, heart attack, and stroke. Therefore, we strongly advise you to completely avoid smoking for your own safety.
- Bone strength: When this vaccine is used for a long time (more than 2 years), there is a chance that the calcium level in the body will decrease and bones will become weak (Osteoporosis). Therefore, unless other birth control methods are not suitable for you, talk to your doctor again about continuing to use this vaccine for more than 2 years. Also get advice on how to get calcium and vitamin D to keep your bones strong.
- No protection against sexually transmitted diseases: This is also very important. This vaccine prevents pregnancy, but it does not provide any protection against HIV (AIDS) or other sexually transmitted diseases (STDs). Therefore, to protect yourself from such diseases, you must definitely use a barrier method such as condoms.
- Regular medical checkups: While taking this vaccine, it is important to see your doctor at regular intervals. It is important to have regular breast exams and Pap smears.
- Overdose: As this vaccine is administered by a medical professional, the risk of overdose is very low. However, if you suspect that this has happened, immediately inform the National Poisons Information Centre at the Colombo National Hospital or the nearest Emergency Treatment Unit (ETU).
What are the possible side effects?
As with any medicine, this vaccine can have side effects. Some are serious, some are common. It is important to be aware of these.
| Serious side effects that require immediate medical attention (go to the Emergency Department - ETU) | |
|---|---|
| ⚫ Sudden severe headache | ⚫ Chest pain, difficulty breathing |
| ⚫ Vision changes (blurred vision, double vision) | ⚫ Difficulty speaking or understanding, memory loss |
| ⚫ Sudden numbness or weakness of the face, arm, or leg (especially on one side of the body) | ⚫ Pain, swelling, redness, and warmth in the leg (signs of a blood clot) |
| ⚫ Yellowing of the skin or eyes, dark urine, pale stools | ⚫ A lump or change in the breast, a discharge from the breast |
| Normal, but tell your doctor if it persists or is bothersome. | |
| ⚫ Breast pain or tightness | ⚫ Mood swings, mild depression |
| ⚫ Stomach ache, stomach fullness | ⚫ Changes in menstrual cycle, light bleeding |
| ⚫ Hair loss, weight changes | ⚫ Vaginal itching, signs of infection |
If you experience any other unusual symptoms not mentioned in this list, talk to your doctor about them as well.
Take-Home Message
- This is a hormonal birth control shot that is taken once a month.
- Before getting the vaccine, be sure to tell your doctor about all your medical conditions and all medications you are taking.
- This vaccine does not provide any protection against sexually transmitted diseases, including HIV (AIDS). Use a method such as a condom.
- If you are a smoker, especially a woman over the age of 35, this vaccine may not be suitable for you as the risk of blood clots and stroke is very high.
- If you experience a serious side effect such as sudden chest pain, difficulty breathing, difficulty speaking, or numbness on one side of the body, go to the nearest Emergency Department (ETU) immediately.
- Before choosing any birth control method, discuss the pros and cons with your doctor and choose the method that best suits you.
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