Sayana Press Injection

Sayana Press Contraceptive Injection

What is Sayana Press used for?

Sayana Press is a contraceptive in the form of an injection used to prevent pregnancy.

Unlike the combined pill, there’s nothing to remember daily. A single injection provides contraceptive cover for three months at a time. You can administer doses yourself at home.

Sayana Press doesn’t protect you against sexually transmitted infections, including HIV. Condoms should be used alongside it if STI protection is needed.

How does the Sayana Press injection work?

Sayana Press contains MPA (medroxyprogesterone acetate), a synthetic form of progesterone, which is a hormone your body naturally produces during the second half of your menstrual cycle. When you use the contraceptive injection, MPA is slowly released into your bloodstream, providing continuous protection without the need for a daily contraceptive pill.

Sayana Press prevents pregnancy primarily by stopping the release of an egg from your ovaries each month. Without ovulation, there is no egg to be fertilised.

Who can use Sayana Press contraception?

Sayana Press is suitable for women who need reliable long-term contraception.

Do not use Sayana Press if you:

• Are pregnant or think you might be pregnant
• Have unexplained vaginal bleeding
• Have liver disease
• Have had or think you have cancer of the breast or sex organs
• Have a blood clot in a vein, or a history of blood clotting disorders
• Have problems with your circulation
• Have been diagnosed with thinning or weakening of your bones (osteoporosis)
• Have had a disease affecting the blood vessels of the brain
• Have or have ever been diagnosed with a meningioma (a usually benign tumour of the tissue surrounding the brain and spinal cord)
• Are allergic to MPA or any other ingredient in Sayana Press

Speak to your GP or doctor before using Sayana Press if you have or have had any of the following:

• Migraine headaches
• Diabetes or a family history of diabetes
• A history of heart disease or high cholesterol
• Depression or a history of depression
• Irregular, light or heavy periods
• A stroke or blood clot in the lung or eye
• Breast nodules, lumps or an unusual breast x-ray
• Kidney disease
• High blood pressure
• Asthma
• Epilepsy
• A strong family history of osteoporosis or risk factors such as chronic alcohol use, smoking, low body weight or long-term use of steroids

How to Inject Sayana Press

The injection is given under the skin into the front upper thigh or abdomen. Each dose is 104mg, injected every 12 to 13 weeks (no later than 14 weeks after your last injection).

1. Wash and dry your hands thoroughly.
2. Choose an injection site on your abdomen or front upper thigh. Rotate the site with each new injection. Don’t inject into scarred skin, bony areas or close to the navel.
3. Check the foil pouch is sealed and undamaged, and that the expiry date has not passed.
4. Tear open the foil pouch and remove the injector. Don’t remove the needle shield yet.
5. Check the injector. There should be a visible gap between the needle shield and the port. If it’s damaged, the gap is missing, or the needle shield has come off, discard it and use a new one.
6. Hold the injector firmly by the port and shake vigorously for at least 30 seconds to mix the medicine. The suspension should appear evenly white. If there is any delay before injecting, shake again.
7. Activate the injector by holding the needle shield with one hand and pushing it firmly towards the port until no gap remains.
8. When ready, pull off the needle shield.
9. Gently pinch a large area of skin. With your other hand, hold the injector by the port with the needle pointing downwards and insert the needle into the skin until the port just touches the surface.
10. Squeeze the reservoir slowly and steadily over 5 to 7 seconds to inject the full dose. Don’t rush – squeezing too quickly may cause resistance.
11. Gently pull the needle out and release the skin. Press lightly on the injection site with a clean cotton pad for a few seconds. Don’t rub.
12. Dispose of the used injector immediately into a sharps container. Never recap the needle or reuse the injector.

A small amount of medicine left around the inside edge of the reservoir after injection is normal. If you think the full dose was not given, don’t inject a second dose. Contact your healthcare provider for advice.

Your first injection must be given within the first 5 days of your menstrual cycle to rule out pregnancy. If switching from another contraceptive, speak to your doctor or pharmacist about timing.

Side Effects of Sayana Press

Like all medicines, this injection may cause side effects, although not everyone gets them.

Common side effects (may affect up to 1 in 10 people) include:

• Changes to your periods, including irregular bleeding, heavier or more frequent bleeding, or periods stopping altogether
• Headache
• Weight increase
• Acne
• Breast pain or tenderness
• Depression, mood changes or irritability
• Tiredness
• Anxiety or difficulty sleeping
• Decreased sexual feeling
• Dizziness
• Back pain or pain in the limbs
• Vaginal irritation or itching
• Nausea or abdominal cramps
• Injection site reactions, including pain, tenderness, a lump or skin dimpling

Uncommon side effects (may affect up to 1 in 100 people) include:

• Vaginal dryness or discharge
• Pain during sex
• Hot flushes
• Hair loss or abnormal hairiness
• Fluid retention or bloating
• Joint or muscle pain
• Migraine
• High blood pressure
• Rash or itching
• Loss of bone mineral density

Rare side effects (may affect up to 1 in 1,000 people) include:

• Breast cancer
• Skin changes at the injection site

Seek immediate medical help if you experience any of the following:

• Sudden wheeziness, difficulty breathing, dizziness, swelling of the eyelids, face, lips or throat, or a skin rash – these may be signs of a serious allergic reaction
• An unusual sudden cough (which may bring up blood), severe chest pain, sudden breathlessness, severe dizziness or a rapid heartbeat – these may be signs of a blood clot in the lungs
• Severe pain or swelling in your legs or feet, accompanied by warmth or discolouration – these may be signs of a blood clot in the leg
• Sudden loss of vision, pain or swelling of the eye – these may be signs of a blood clot in the eye
• Weakness or numbness in the face, arm or leg, sudden confusion, trouble speaking, severe headache with no known cause or loss of consciousness – these may be signs of a stroke

If you get any side effects not listed here, or any that concern you, speak to your doctor or pharmacist. You can also report side effects via the MHRA Yellow Card Scheme.

Sayana Press Contraceptive Injection Ingredients

Active ingredient: Medroxyprogesterone acetate 104mg

Other ingredients: Macrogol, methyl parahydroxybenzoate (E218), propyl parahydroxybenzoate (E216), sodium chloride, polysorbate 80, monobasic sodium phosphate monohydrate, disodium phosphate dodecahydrate, methionine, povidone, sodium hydroxide and/or hydrochloric acid (for pH adjustment) and water for injection.

Warnings and Precautions

• Sayana Press does not protect you against sexually transmitted infections, including HIV. Use condoms if STI protection is needed.
• Most women experience changes to their bleeding patterns. After 12 months of use, around 60% of women have little or no bleeding at all.
• Sayana Press lowers oestrogen levels, which can reduce bone mineral density over time. This effect is greatest in the first 2 to 3 years of use. Bone density tends to stabilise with continued use and shows some recovery after stopping. Regular weight-bearing exercise and a diet with adequate calcium and vitamin D can help support bone health during treatment.
• Use of MPA has been linked to the development of meningioma, a usually benign tumour of the tissue surrounding the brain and spinal cord. The risk increases with longer duration of use. Tell your doctor immediately if you notice changes in vision, hearing loss or ringing in the ears, loss of smell, worsening headaches, memory loss, seizures, or weakness in your arms or legs.
• There is a slightly increased risk of breast cancer in women using injectable contraception compared to those who don’t use any hormonal contraception. This risk reduces after stopping and returns to normal within 10 years.
• Some women using hormonal contraceptives report depression or low mood. Speak to your doctor as soon as possible if you experience mood changes or depressive symptoms.
• Stop using Sayana Press and seek medical advice if you develop jaundice, a new or worsening migraine, or sudden vision changes.
• Tell your doctor or pharmacist about all medicines you are taking, including over-the-counter medicines. Anticoagulants (blood-thinning medicines) may interact with Sayana Press.
• Don’t use Sayana Press if you are pregnant. If you become pregnant while using it, tell your doctor immediately.
• If you are breastfeeding, the first injection should be given no sooner than 6 weeks after giving birth.
• Keep out of the sight and reach of children.
• Store below 25°C. Don’t refrigerate or freeze.
• Don’t use after the expiry date printed on the injector, foil pouch and carton.
• Dispose of used injectors in a sharps container in line with local authority requirements. Ask your pharmacist for guidance.