A clinical evaluation of bleeding patterns, adverse effects, and satisfaction with the subdermal etonogestrel implant among postpartum and non‐postpartum users

Wahab, Noraziana Abd.; Rahman, Nor Azlina A; Mustafa, Kamarul Bahyah; Awang, Mohd Shukrimi; Sidek, Ayu Aszliana; Ros, Razman M.

doi:10.1016/j.ijgo.2015.07.022

Cited by 3 publications

(10 citation statements)

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“…Seven studies looked at post‐partum insertion as a predictor, either as a primary or secondary variable 9–11,13,15,17 , 19 . None found statistically significant differences in unfavourable bleeding patterns between post‐partum and non‐post‐partum insertion.…”

Section: Resultsmentioning

confidence: 99%

“…None of the seven studies which assessed or reported the effect of post-partum status showed an effect on bleeding pattern. [9][10][11]13,15,17,19 Breastfeeding is likely to influence bleeding patterns since exclusive breastfeeding can inhibit ovulation, but it was reported in only two of the seven papers which included post-partum women. 11,17 In one of these, 11 a retrospective study, breastfeeding at the time of insertion is recorded but not at the time of reported bleeding complaints.…”

Section: Discussionmentioning

confidence: 99%

“…Bleeding patterns were reported according to WHO definitions by Vieira et al 10 and Wahab et al, 13 but 'favourable' and 'unfavourable' bleeding patterns had to be calculated, extrapolated, or estimated for Lazorwitz et al, 8 Casey et al, 11,17 Bryant et al 9 and Obijuru et al 18 The period in which bleeding complaints were reported varied between 6 months after insertion to 36 months. Di Carlo et al 12 used WHO reported measure of bleeding but amalgamated the data to produce two groups of women with 'favourable' or 'unfavourable' bleeding' in more than 50% of 'reference periods'.…”

Section: Discussionmentioning

confidence: 99%

“…Two studies were non-blinded randomised controlled trails 9,10 ; three were prospective cohort studies, [11][12][13] one was a cross-sectional study comparing bleeding patterns and potential predictors at a single point in time, 8 seven were retrospective cohort studies (Table 2). [14][15][16][17][18][19][20] Predictors identified by the included studies were timing of postpartum insertion, age, Body Mass Index (BMI), tobacco use and parity or gravidity.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The study found no statistically significant difference in bleeding rates at 3 months, although there was a trend towards greater amenorrhoea in the post-partum group. 13 The authors excluded nulliparous women from their recruited sample, and do not comment on whether postpartum women were breastfeeding. Since breastfeeding is likely to affect post-partum bleeding patterns, this is a limitation of the study.…”

Section: Post-partum Insertionmentioning

confidence: 99%

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Systematic review of factors predictive of unfavourable vaginal bleeding in women of reproductive age using the contraceptive etonogestrel implant

Walker

Claydon

Kabir

et al. 2023

Repro Female Child Health

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Introduction: This systematic review sought predictors of unfavourable bleeding profiles in women using the etonogestrel contraceptive implant. Unfavourable bleeding is common and a leading cause of requests for removal. Methods: We included randomised controlled trials (RCTs), and prospective and retrospective cohort studies from 1998 to October 2022. Inclusion criteria were healthy women using etonogestrel for contraception. Papers not in English were excluded as were ongoing or incomplete studies. We searched Pubmed, Pubmed Central, MEDLINE (Web of Science & Ovid), Cochrane library, CINAHL Plus, WHO (HINARI), Open Grey and Greynet.org. Risk of Bias was assessed using ROB2 IRPGv9 for RCTs and ROBINS-I for non-RCTs. We conducted a narrative analysis. Results: We included 13 studies. Lower body mass index (BMI), younger age, parity and smoking status were statistically, significantly associated with unfavourable bleeding patterns in one or more studies. No studies reported post-partum status having a significant association with unfavourable bleeding. The available data was too limited and too heterogeneous to perform a robust meta-analysis. Discussion: Heterogeneity in reported outcomes and timescales limited the accuracy of synthesis. Risk of bias was moderate to serious in non-RCTs due to baseline differences and missing or imputed data. The protective effect of higher BMI for unfavourable bleeding is in keeping with previous reviews and studies and is a clinically important finding.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Post-partum Insertionmentioning

confidence: 99%

See 3 more Smart Citations

Systematic review of factors predictive of unfavourable vaginal bleeding in women of reproductive age using the contraceptive etonogestrel implant

Walker

Claydon

Kabir

et al. 2023

Repro Female Child Health

View full text Add to dashboard Cite

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Descripción de efectos secundarios en usuarias del implante de etonogestrel en Honduras durante marzo 2017 a mayo 2018

José¹,

Pereira²

2020

Rev Peru Investig Salud

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Introducción: El implante anticonceptivo de etonogestrel es un método moderno, que ofrece a las usuarias una eficacia anticonceptiva hasta de un 99% en un periodo de 3 años; es seguro cómodo y accesible. Como todo fármaco tiene efectos secundarios, se describen así: amenorrea, sangrado uterino disfuncional, acné, náusea, cefalea. Objetivo: Determinar cuáles son los efectos secundarios más frecuentes en usuarias del implante subdérmico de etonogestrel, en Tegucigalpa Honduras, durante marzo 2017 a mayo 2018. Material y método: Estudio descriptivo, transversal, en usuarias del implante en un policlínico de Tegucigalpa, Honduras. La muestra incluyó mujeres en edad fértil que voluntariamente solicitaron el implante anticonceptivo para utilizarlo por primera vez; los criterios de inclusión fueron: utilización del implante de etonogestrel como método anticonceptivo. Resultados: Se incluyeron 115 mujeres que cumplieron criterios de inclusión. El efecto secundario más frecuente fue la amenorrea, afirmado por 78(68%), seguido de cefalea 29(25%), sangrado uterino disfuncional 28(24%), tuvieron otros efectos secundarios como aumento de peso, mastalgia, acné, náuseas y otros. A pesar de los efectos secundarios 99 (86%) de las mujeres continúan utilizando el implante y 109(95%) de ellas lo recomendarían a otras mujeres para su uso como método anticonceptivo. Conclusión: El efecto secundario más frecuente en usuarias del implante de etonogestrel es la amenorrea, seguido de cefalea y sangrado uterino disfuncional.

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Efecto del implante anticonceptivo sub-dérmico de Etonogestrel sobre el peso corporal en mujeres en edad reproductiva

Urdaneta M,

Fernández C,

Baabel-Zambrano

2023

Rev. chil. nutr.

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Investigación comparativa, con diseño cuasi experimental, de casos y controles, a etiqueta abierta y prospectivo; en la que se propuso comparar el efecto sobre el peso corporal de un implante contraceptivo sub-dérmico liberador de ENG en pacientes de la consulta de planificación familiar ABSTRACT Aim: To analyse the effect on body weight of continuous hormonal contraception by releasing subdermal implant etonogestrel (ENG) in women of reproductive age treated in the family planning consultation of a Venezuelan hospital. Methods: Comparative and applied research, with quasiexperimental, case-control, open label and prospective design, with an intentional sample of 60 women separated to receive the contraceptive implant (Implanon NXT®; cases) or a cooper intrauterine device (IUD) (Cooper T; controls) was carried out. Body weight and body mass index were evaluated before and after 12 months of contraceptive use; as well as demographic characteristics of users, side effects, and contraceptive effectiveness of each method. Results: After one year with the ENG implant, no significant variations were found with respect to initial measurements of body weight (61.21±8.30 vs. 61.23±9.50, p>0.5) and BMI (25.23±3.89 vs 25.26±4.30; p>0.05); on the contrary, to what was observed among IUD users where both body weight and BMI had a significant increase (P<0.05). Likewise, most users remained in the same weight range as when starting the method (p<0.001); while weight gain was greater among IUD users (1,530±2.04 vs. 3,700±3.02; p<0.05). Conclusions: The ENG implant does not produce an increase in body weight after 12 months of use, with minimal adverse effects and high contraceptive efficacy.

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A clinical evaluation of bleeding patterns, adverse effects, and satisfaction with the subdermal etonogestrel implant among postpartum and non‐postpartum users

Cited by 3 publications

References 4 publications

Systematic review of factors predictive of unfavourable vaginal bleeding in women of reproductive age using the contraceptive etonogestrel implant

Systematic review of factors predictive of unfavourable vaginal bleeding in women of reproductive age using the contraceptive etonogestrel implant

Descripción de efectos secundarios en usuarias del implante de etonogestrel en Honduras durante marzo 2017 a mayo 2018

Efecto del implante anticonceptivo sub-dérmico de Etonogestrel sobre el peso corporal en mujeres en edad reproductiva

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