Self-reported bleeding patterns during extended etonogestrel implant use beyond 3 years
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Juliana de Toledo Piza Soares1, Paula da Cunha Pereira1, Mariana R B Rossi-Elias1
1Department of Obstetrics and Gynecology, Faculty of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil.
Objective:
To describe self-reported bleeding patterns among etonogestrel implant users beyond 3 years of use and assess perceived changes compared withthe first 3 years.
Methods:
We conducted a cross-sectional study at University State of Campinas, Brazil, among women who continued using the same etonogestrel implant beyond 3 years after insertion. Participants completed a structured questionnaire assessing their usual bleeding characteristics during extended use, including bleeding/spotting episodes per month, bleeding/spotting days per month, and bleeding flow. They also reported perceived changes in these characteristics compared with the first 3 years of use.
Results:
We included 153 women. The median age was 32 years (IQR 26-37), and the median body mass index (BMI; kg/m2) was 26.6 (IQR 23.8-30.1). The median duration of implant use was 3.9 years (IQR 3.40-5.08). Amenorrhoea was reported by 24.2%, and the median number of bleeding/spotting episodes and days per month was 1 (IQR 0-2) and 4 (IQR 0-7), respectively. Compared with the first 3 years, 62.7% reported unchanged or fewer bleeding episodes, 62.1% reported unchanged or fewer bleeding days, and 58.8% reported unchanged or reduced bleeding flow.
Conclusion:
Among women who continuied etonogestrel implant use beyond 3 years, approximately one-quarter reported amenorrhoea, and most perceived no increase in bleeding frequency, duration, or flow compared with the first 3 years. However, these findings should be interpreted with caution because of the retrospective assessment and potential selection bias.
