Sayana Press: The self-administered contraceptive

New innovations are being registered in birth control methods and the latest one is the Sayana Press; a self-injectable family planning method - a short term method in the family of injectable Depo-Provera.

They both have the same birth control drug but Depo- Provera must be administered by a qualified health worker.  Sayana Press on the other hand, can be self-administered anywhere, anytime.

Justine Namakula, a midwife, who works with Population Services International (PSI Uganda), says the easy-to-use hormonal birth control for women is an injection with a tiny needle that women can administer to themselves to prevent pregnancy for three months.

An injection every three months

It comes pre-filled with the drug, so the injection is ready to use. You, therefore, need a new injection after every three months.

 “The method saves women time because they do not have to line up at health centres waiting for an injection,” Namakula says.  She adds that first-time users need to do it under the supervision of a health worker.  “The first injection has to be done at the health facility because the health worker has to train you on how to use it,” Namakula says.

Dr Geofrey Kilama, a gynaecologist at Marie Stopes Uganda, says Sayana Press was rolled out in the country in March 2015 and a high uptake has been registered. 

How it is administered

“The Sayana Press is administered into the fatty layer of the skin on the thigh or lower abdomen. Remember to avoid the naval and the bony areas,” he explains.

Namakula says Sayana Press is accessible and available in all government health facilities, private facilities as well as Profam clinics and it goes for Shs3,000 while in some places a pack of three goes for Shs5,000.

Experts says once users self-inject for the first time, they overcome the fear and are able to do it wherever they are. Skin irritation at the site of the prick is normal, according to medics, but it should not exceed two days, they warn. “Do not massage the site after the injection. Seek medical help if the irritation recurs for days.  If you get a problem with the method, consult a health worker,” Dr Kilama advises.

Possible side effects include prolonged or heavy bleeding, dizziness, headache, spotting, absence of periods, weight gain, changes in moods and low sexual drive.

Reason not to have an injection

Sayana Press should not be used if a pregnancy is suspected or if the woman is suspected to have a tumor of the breast or genital organ. Women with undiagnosed vaginal bleeding, severe liver impairment, heart conditions, stroke or clot, those that have been diabetic for more than 20 years, hypertensive and lactating mothers before six weeks should not use Sayana Press.

How it is used

Sayana Press comes in a small, rectangular pouch that is easy to store and it should be stored safely out of reach of children or animals.  Women are advised to take the injection after a bath and it should be stored at room temperature.

Experts say it is important to shake the injector vigorously for at least 30 seconds to mix the medicine by holding the injector firmly by the port.

Safe and effective

Dr Kilama says, “After shaking, the medicine should appear white and uniform and if it is not, discard the injector and use a new one.  If you self-inject, the drug will remain in the injector and you will just have water in the body and you may become pregnant,” he says.

Namakula says: “Hold the port up with one hand then close the gap to activate the injector. Push the needle shield firmly towards the port until you hear the popping sound like the click of a pen. Remove the shield from the needle.”

Does not prevent  STDs

Dr Kilama says Sayana Press is safe and effective in preventing unwanted pregnancies because it contains progesterone- a sex hormone involved in the menstrual cycle, pregnancy,  embryogenesis of humans and other species.

“Women should know that the Sayana Press does not cause infertility. However, it may take up to 12 months before returning to fertility after an exposure, but the time varies in different women. Sayana Press only prevents pregnancy but does not prevent sexually transmitted diseases and infections,” he warns.