Combined Contraceptive Injections

Cyclofem, Lunelle, Mesigyna

Combined Contraceptive Injections
Combined Contraceptive Injections. Photo © Dawn Stacey

Definition of Combined Contraceptive Injection:

A combined contraceptive injection is a monthly birth control shot that contains the combination of estrogen and progestin. Like Depo-Provera and the Noristerat shot, combined contraception injections are a type of hormonal birth control. Some of these injections include Cyclofem, Lunelle, and Mesigyna.

When to Get Your Combined Contraceptive Injection:

Monthly combined contraceptive injections are very much like combination birth control pills.

The estrogen and progestin hormones are injected into the muscle of your upper arm, thigh, or buttocks. After each shot, the hormone levels peak and then slowly decrease until the next injection. In order to be effective, you must get a combined contraceptive injection every 28 to 30 days (and you cannot go past 33 days from the date of your last injection). When you get your shot within this timeframe, combined contraceptive injections have a failure rate of between less than 1% to 6% each year -- this means that they are 94% to 99% effective at preventing pregnancy.

How Do Combined Contraceptive Injections Work?

The hormones delivered by a combined contraceptive injection mainly work to prevent pregnancy for one month by:

  • Preventing you from ovulating (releasing an egg).
  • Thickening your cervical mucus (this makes it harder for sperm to swim through).
  • Thinning the lining of the uterus (making it more difficult for implantation to take place).

    It is also thought that monthly combined shots may provide additional non-contraceptive health benefits. If you get pregnant when on your combined contraceptive injection, this birth control shot will not hurt your baby. It will also not cause your pregnancy to terminate. After stopping your combined contraceptive injection, there may be a delay in regaining fertility (ability to get pregnant) -- your fertility should return within a few months after your last injection.

    Combined Contraceptive Injections Side Effects

    Because they are so similar to other combination hormonal methods (like the pill, the patch, and NuvaRing, combined contraceptive injections will typically have the same types of side effects as these combo methods. Monthly combined injections contain less progestin than Depo-Provera and Noristerat (which are progestin-only contraceptive shots). If you use combination contraceptive shots -- as compared to progestin-only injections -- you:

    Types of Combined Contraceptive Injections - Lunelle:

    Lunelle was a monthly combined injection made up of pre-filled estradiol cypionate and medroxyprogesterone syringes. It became available in the United States in 2000. The Lunelle syringes were voluntarily recalled in 2002 due to concern over potency and possible risk of contraceptive failure.

    In October 2003, Pfizer stopped making Lunelle, so it is no longer available in the United States.


    A similar combined contraceptive injection is now sold under the name Cyclofem (also known as Lunelle, Cyclofemina, Feminena, Novafem, Lunella, and Cyclo-Provera). It is available mainly in  Latin America, Africa, and Asia -- but you cannot get it in the United States. 


    Mesigyna (also known as Norigynon, Mesigyna Instayect, Mesygest, and No 3 injectable Norigynon) is another type of combined contraceptive injection. It is made up of estradiol valerate and norethisterone enanthate. It just as effective as Cyclofem -- but it is also not available in the United States. Mesigyna is primarily available in Latin America and Asia.


    Bassol S et al. "Mesigyna once-a-month combined injectable contraceptive: Experience in Latin America." Contraception. 2000; 61(5):309-16. Full article accessed via private subscription.

    Hassan EO, el-Nahal N, el-Hussinie M. "Once-a-month injectable contraceptives, Cyclofem and Mesigyna, in Egypt. Efficacy, causes of discontinuation, and side effects." Contraception. 1999; 60(2):87-92. Full article accessed via private subscription.

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