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Implantable contraception.
1Department of Obstetrics, Gynecology and Reproductive Sciences, San Francisco General Hospital, Center for Reproductive Health Research and Policy, University of California, San Francisco 94110, USA.
Summary
Progestogen-only contraceptive implants, like the new Implanon, offer effective, long-term birth control with fewer side effects than other methods. Implanon provides easy insertion and removal, making it a convenient contraceptive option.
Area of Science:
- Reproductive Health
- Contraception
- Pharmacology
Background:
- Progestogen-only contraceptive implants offer long-acting reversible contraception.
- Previous formulations like Norplant have faced challenges with insertion and removal.
- Implanon represents a new generation of single-rod etonogestrel-releasing implants.
Purpose of the Study:
- To review the advantages and disadvantages of progestogen-only contraceptive implants.
- To evaluate the development and characteristics of Implanon.
- To compare Implanon with existing contraceptive methods.
Main Methods:
- Review of existing literature on progestogen-only contraceptive implants.
- Analysis of data regarding Implanon's efficacy, safety, and user acceptability.
- Comparison of Implanon's performance with oral contraceptives, depot injections, and intrauterine devices.
Main Results:
- Implants provide steady serum progestogen levels for 1-5 years, avoiding oral contraceptive peaks/troughs and depot injection ovarian suppression.
- Implanon demonstrates ease of insertion/removal with minimal complications and pain.
- The primary discontinuation reason is altered bleeding patterns, often managed with counseling; ectopic pregnancy and follicular hypertrophy rates are low.
- Implanon shows an extremely high efficacy (Pearl Index of 0) with a new polymer and less androgenic progestogen.
Conclusions:
- Progestogen-only implants, particularly Implanon, are effective, safe, economical, and convenient contraceptive alternatives.
- Implanon's design facilitates easier insertion/removal and potentially reduces androgenic side effects.
- Improved counseling can mitigate bleeding pattern changes, enhancing user tolerance and overall acceptability.