How Sayana Press Works
Sayana Press contains the active ingredient medroxyprogesterone acetate (MPA), a synthetic form of the hormone progesterone. Once injected, MPA is slowly released into the body over several months to provide effective contraception. It prevents pregnancy by working in three primary ways:
- Prevents ovulation: It stops the release of an egg from the ovaries each menstrual cycle.
- Thickens cervical mucus: This creates a physical barrier that makes it more difficult for sperm to travel into the womb and fertilize an egg.
- Thins the uterine lining: The lining of the womb becomes thinner, making it less likely for a fertilized egg to implant.
The convenience of the Uniject™ system, an all-in-one pre-filled and auto-disabled device, is what distinguishes Sayana Press. This design makes the subcutaneous (under the skin) injection simple to use, enabling administration by trained providers, community health workers, or by the women themselves through self-injection.
Benefits of Sayana Press
Sayana Press offers several advantages for users seeking a long-acting, reversible contraceptive option:
- Convenience and Autonomy: Unlike traditional injectable contraceptives that require a clinic visit for administration, Sayana Press can be self-injected at home, eliminating travel and waiting times.
- Long-Lasting Protection: A single injection provides effective contraception for 13 weeks (approximately three months).
- High Effectiveness: It is more than 99% effective at preventing pregnancy with correct and timely use, making it one of the most effective reversible methods.
- Independent of Daily Routine: Because it only requires attention every three months, it removes the need for a daily pill, which can increase compliance.
- Breastfeeding-Friendly: Sayana Press is safe to use for women who are breastfeeding, typically starting no sooner than six weeks postpartum.
- Not Affected by Other Medications: Most medications do not interfere with its effectiveness, unlike some oral contraceptives.
Potential Side Effects and Health Considerations
Like all medications, Sayana Press can cause side effects. Many users experience changes in their menstrual bleeding patterns, especially within the first few injections.
- Irregular Bleeding: This is the most common side effect and can include spotting, irregular or prolonged bleeding. Over time, many users find that their periods become lighter, shorter, or stop completely.
- Weight Gain: Some women may experience an increase in weight while using the injection.
- Mood Changes and Headaches: Other reported side effects include headaches, mood changes, and breast tenderness.
- Delayed Return to Fertility: After stopping Sayana Press, it can take some time for fertility to return to normal. While many women will conceive within a year, some may experience a delay of up to 18 months.
- Bone Mineral Density (BMD): Long-term use of Sayana Press can cause a temporary loss of BMD. While this generally reverses when the medication is stopped, doctors may monitor BMD for those using the method for more than two years.
Sayana Press vs. Depo-Provera: A Comparison
Sayana Press and Depo-Provera both contain medroxyprogesterone acetate, but differ in their administration and formulation. The following table highlights the key differences:
| Feature | Sayana Press (DMPA-SC) | Depo-Provera (DMPA-IM) |
|---|---|---|
| Injection Type | Subcutaneous (under the skin) | Intramuscular (deep into the muscle) |
| Administration | Designed for self-injection at home after initial training. | Typically administered by a healthcare professional at a clinic. |
| Formulation | Lower dose of MPA. | Higher dose of MPA. |
| Device | Pre-filled, auto-disabled Uniject™ device. | Separate vial and syringe. |
| Benefits | Increased autonomy, more discreet, and easier to administer. | Long-established, highly effective form of contraception. |
How to Administer a Sayana Press Injection
Proper training from a healthcare professional is required before starting self-injection. The following is a general guide, but specific instructions should be followed as demonstrated by your provider:
- Preparation: Wash your hands thoroughly. Have the Sayana Press device (at room temperature), a clean tissue, and a sharps container ready. Select an injection site, such as the upper thigh or abdomen, and clean it with an antiseptic wipe.
- Mix the Solution: Hold the injector firmly and shake it vigorously for at least 30 seconds to ensure the solution is a uniform, milky white consistency.
- Activate the Device: With the needle pointing upwards, push the needle shield firmly into the port until it clicks and stops. This breaks an inner seal.
- Inject: Pinch a fold of skin at the chosen site. Insert the needle completely into the pinched skin at a downward angle until the port touches the skin. Slowly press the reservoir for 5–7 seconds to inject the medicine.
- Finish: Gently pull the needle out, release the skin fold, and press lightly with a tissue. Do not rub the injection site. Immediately dispose of the used device in a sharps container.
Conclusion
Sayana Press represents a significant advancement in contraceptive accessibility, particularly in low-resource settings, by enabling safe and convenient self-administration. The ability to self-inject gives women more control over their healthcare and reduces reliance on clinic visits. While it offers high efficacy and convenience, users must be aware of potential side effects such as irregular bleeding and delayed return to fertility. A thorough discussion with a healthcare provider is essential to determine if Sayana Press is the right contraceptive method based on an individual's health and lifestyle needs. For those seeking a reliable, discreet, and long-acting option, Sayana Press is a powerful tool for family planning.
Learn more about how organizations like PATH championed the development and delivery of Sayana Press to expand contraceptive access worldwide here: DMPA-SC self-injectable contraception - PATH
