Estradiol cypionate/medroxyprogesterone acetate

Estradiol cypionate/medroxyprogesterone acetate (EC/MPA), sold under the brand name Cyclofem among others, is a form of combined injectable birth control. It contains estradiol cypionate (EC), an estrogen, and medroxyprogesterone acetate (MPA), a progestin. It is recommended for short-term use and is given once a month by injection into a muscle. Common side effects of EC/MPA include irregular menstrual periods which typically improves with time. Other side effects include blood clots, headache, hair loss, depression, nausea, and breast pain. Use during pregnancy is not recommended. Use during breastfeeding is likely safe. It works mainly by preventing ovulation. EC/MPA came into medical use in 1993 with approval in the United States in 2000. It is on the World Health Organization's List of Essential Medicines. The medication is approved for use in 18 countries. It is used in Mexico, Thailand, and Indonesia, among other countries. It is no longer commercially available in the United States. EC/MPA is used as a once-monthly combined injectable contraceptive to prevent pregnancy in women. EC/MPA is available in the form of a microcrystalline aqueous suspension of 5 mg EC and 25 mg MPA given in a 0.5 mL aqueous solution for intramuscular injection once per month. It is provided in the form of single-dose vials and ampoules. The particle sizes of the formulation are 93% within a range of 5 to 16 μm. Depot MPA (DMPA) and EC/MPA were developed by Upjohn in the 1960s. DMPA (brand name Depo-Provera) was introduced for use as a progestogen-only injectable contraceptive for the first time outside of the United States in 1969 and was subsequently approved for use in birth control in the United States in 1992. A variety of preliminary studies on EC/MPA as a contraceptive were published between 1968 and 1978. In the late 1970s, the World Health Organization (WHO) began an initiative known as the Special Programme of Research, Development and Research Training in Human Reproduction (WHO/HRP) to develop combined injectable contraceptives as part of its efforts to increase the availability and choices of birth control for women and men throughout the world.