Bleeding related to etonogestrel subdermal implant in a US population

Casey, Petra M.; Long, Margaret E.; Marnach, Mary L.; Bury, Jessica E.

doi:10.1016/j.contraception.2010.09.012

Cited by 54 publications

(60 citation statements)

References 21 publications

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“…The findings about side-effects may appear concerning, but are similar to studies of removers elsewhere, [12] as are the high levels of acceptability among users, who commonly make up about 80% of all those who insert the implant. [13][14][15][16] The motivations for implant use were strongly tied to the method's convenience, such as its long action and lack of requirement for adherence by the user. Reductions in clinic visits were especially important for women working or studying.…”

Section: Discussionmentioning

confidence: 99%

User perspectives on Implanon NXT in South Africa: A survey of 12 public-sector facilities

et al. 2017

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Background. Implanon NXT, a long-acting reversible contraceptive, was introduced in South Africa (SA) in early 2014, aiming to expand the method mix and increase its effectiveness. Initial uptake was high, but has since declined considerably. In these early years after the implant's introduction, it is important to identify reasons for the decline, and remedy gaps in services. Objectives. To determine periods of use, reasons for the use and early removal of the implant Implanon NXT. Methods. In 2016, we recruited 152 women from six clinics in the City of Johannesburg, and six in North West Province, SA. A semistructured interview was administered to 91 women currently using the implant and 61 previous users. We examined user perspectives, factors influencing women's experiences with the implant and reasons for discontinuation. Results. The participants' mean age was 30 years, with only 15% aged <25. Implant uptake was motivated by convenience (less frequent visits required than for short-acting methods) and by favourable views of the method among friends, family and healthcare providers. Only about a quarter of women recalled being counselled pre-insertion about implant effectiveness, and half about side-effects pre-insertion. Among discontinuers, the median time to device removal was 8 months (interquartile range 6 -12), and this was primarily as a result of sideeffects (90%), especially bleeding-pattern changes and headaches. Removals were most common among married and cohabiting women, often ascribed to the effects of bleeding on their sexual relationships. Rumours and misinformation contributed to some removals. Overall, women's experiences with the implant were rated 'good' or 'very good' by 74% of those continuing use, many of whom reported not having experienced any side-effects or that these had diminished over time. Conclusion. Levels of acceptability among continuing users were high, mainly linked to the method's convenience. While early favourable views drove uptake, negative perceptions, if unaddressed, may now undermine services. Deficiencies in counselling around effectiveness and side-effects may extend to contraceptive services more generally. Women require more intensive support when experiencing sideeffects, including effective systematic approaches to ameliorating bleeding and headaches. Implant services could specifically target young women and first-time contraceptive users. These actions together could reverse the persistent decline in implant use in SA.

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Section: Discussionmentioning

confidence: 99%

User perspectives on Implanon NXT in South Africa: A survey of 12 public-sector facilities

et al. 2017

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“…Counselling focused on the particular effi cacy and benefits of LARCs is able to lower the rates of pregnancy and abortion in adolescents and young women. [56] In one large study, two-thirds of youth were still using a LARC after 2 years, compared with Bleeding side-e ects [23,38,39,[81][82][83][84][85] Headache [38] Continuation rates all women (12 months) [23,37,40,82,83,86] Continuation rates adolescents and women <25 years (12 months) [7,57,87] Continue implant Removal …”

Section: Targeting Of Population Groupsmentioning

confidence: 99%

“…Bleeding side-e ects [23,38,39,[81][82][83][84][85] Headache [38] None Mild Severe [14] CME mainly because of limited nurse training in insertion and suboptimal access in family planning clinics. [15] In addition, the longstanding question of whether depot medroxyprogesterone acetate (DMPA) increases women's risk for HIV acquisition will soon be answered by the Evidence for Contraceptive Options and HIV Outcomes (ECHO) study.…”

Section: Fy 2015 Fy 2016 Fy 2017mentioning

confidence: 99%

Strengthening implant provision and acceptance in South Africa with the ‘Any woman, any place, any time’ approach: An essential step towards reducing unintended pregnancies

et al. 2017

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“…Estas diferencias no se asociaron con las características de las usuarias, tales como la paridad o la edad (16). Además, otro estudio concluyó que los patrones de sangrados no pueden predecirse por estas variables biopsicosocial (23).…”

Section: Discussionunclassified

“…Estas intervenciones han contribuido de manera significativa a la reducción de los retiros prematuros del IASE. De las adolescentes que presentaron sangrado prolongado, sólo una solicitó el retiro anticipado del implante, a diferencia de otros estudios que reportan hasta 23% de retiros durante el primer año debido a los sangrados prolongados (12,23).…”

Section: Discussionunclassified

Patrón de sangrado uterino en adolescentes usuarias de implante anticonceptivo subdérmico de etonogestrel

Molina

Montero

et al. 2016

Rev. chil. obstet. ginecol.

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Bleeding related to etonogestrel subdermal implant in a US population

Cited by 54 publications

References 21 publications

User perspectives on Implanon NXT in South Africa: A survey of 12 public-sector facilities

User perspectives on Implanon NXT in South Africa: A survey of 12 public-sector facilities

Strengthening implant provision and acceptance in South Africa with the ‘Any woman, any place, any time’ approach: An essential step towards reducing unintended pregnancies

Patrón de sangrado uterino en adolescentes usuarias de implante anticonceptivo subdérmico de etonogestrel

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