Up to 2 weeks early although not ideal. If a woman returns after the grace period, she can receive the injection if the provider is reasonably sure that she is not pregnant. If she may be pregnant, she should use a barrier method until it is clear whether or not she is pregnant. There is no cumulative effect of injectables, and extended amenorrhea is not a medical problem. It may be an advantage in areas where anemia is common.
Counseling can reassure the user who is worried about amenorrhea.
If available, a pregnancy test may be helpful, but it is not required. Study Findings DMPA and NET EN Monthly Injectables Findings Ref. Most studies find no effect. Most studies find no effect. 331 Carbohydrate metabolism Do not induce diabetes in normal women but may significantly increase glucose and insulin levels.