The ECHO Study is designed to assess three highly effective, reversible long-acting contraceptive methods: the progestogen-only contraceptive depot medroxyprogesterone acetate (DMPA), the Jadelle sub-dermal implant and the copper intrauterine device (IUD). All of these methods are private and do not interfere with sex. The specific benefits and side effects of each method are summarised in the following table.

ContraceptiveDMPA Jadelle ImplantCopper T IUD
What it isAlso known as Depo, DMPA is the most widely used progestin-only injectable. It is given by injection into the muscle.This method consists of 2 thin, flexible rods filled with a synthetic progestogen (levonorgestrel) that are inserted just under the skin of a woman’s upper arm.The copper-bearing intrauterine device is shaped like a ‘T’ and is the size of a matchstick. It is made of soft but strong plastic with copper bands and has a ‘tail’ made of 2 strings. The doctor or nurse places it in the womb.
FrequencyGiven every 3 months
Once inserted, lasts up to 5 years, although one can have it removed at any timeOnce inserted, lasts up to 10 years, although one can have it removed at any time
Benefits • Long-acting and privacy of use—given by injection into the muscle
• No interference with sex
• Often stops monthly periods
• Can be used during breastfeeding
• Protects against uterine cancer and uterine fibroids
• Long-acting and privacy of use—inserted underneath skin of the arm
• No interference with sex
• Often stops monthly periods while being used
• Rapid return to fertility once removed
• Often stops monthly periods while being used
• Long-acting and privacy of use
• No delay in return to fertility
• May protect against uterine and cervical cancer
Side Effects• Irregular or prolonged menstrual bleeding initially, followed by infrequent or no bleeding

In some women:
• Reversible reductions in bone density
• Mood changes, including depression
• Weight gain
• Diminished libido

After a year of use, almost half of women stop having a period
Some women have:
• Prolonged/irregular menstrual bleeding
• Application site reactions
• Dizziness
• Headache
• Vaginal discharge
• Breast pain
• Nausea
• Pelvic pain
• Urinary tract symptoms
• Vaginitis
• Weight gain
• Changes in menstrual bleeding (heavier periods and more menstrual cramps) are common, especially in the first 3 to 6 months of use
• Some women have light bleeding between periods
Return to Fertility• There may be a 6-9 month delay in getting pregnant after the last injection.• Rapid return to fertility once removed.Return to fertility can be immediate.