Bone mineral density during long-term use of the progestagen contraceptive implant Implanon® compared to a non-hormonal method of contraception

Abstract

An open, prospective, comparative study was done in healthy women, aged between 18 and 40 years, to study the effects of long-term etonogestrel treatment on bone mineral density (BMD). The control group used a non-hormone-medicated intrauterine device (IUD). The BMD was measured using a dual energy X-ray absorptiometry instrument. Measurements included the lumbar spine (L(2)-L(4)), the proximal femur (femoral neck, Ward's triangle, trochanter) and distal radius. The period of treatment was 2 years and 44 women in the Implanon group and 29 in the IUD group provided data. Groups were comparable at baseline with respect to age, weight, body mass index, BMD and 17beta-oestradiol status. Changes from baseline in BMD in the Implanon group were not essentially different from those in the IUD group. There was no relationship between 17beta-oestradiol concentrations and changes in BMD in this study population. The results of the present study indicate that Implanon((R)) can safely be used in young women who have not yet achieved their peak bone mass.

A perspective on current research investigating the effects of hormonal contraceptives on determinants of female athlete performance

“…e use of an etonogestrel implant (Implanon) has also resulted in body mass increases of 3% over 2 years 25 . is evidence suggests that progestin-only contraceptives may result in greater increases in body mass than combined contraceptives in the general population, although these data may not be applicable to athletes as they exercise frequently and monitor their dietary energy intake closely 15 .…”

“…Synthetic progestins have been hypothesised to act in a glucocorticoid-like manner, which results in increased appetite and visceral fat deposition [27][28][29][30] . Androgenic contraceptives may also interfere with appetite regulation by suppressing the secretion of the satiating hormone cholecystokinin 25 . It is unclear whether the addition of oestrogens in combined contraceptives in uences the e ects of the progestins 26 .…”

“…Several reports of negatives e ects in the general population although no studies have been conducted in athletes [19][20][21][22][23][24][25] .…”

Densitas Massa Tulang Pada Pengguna Kontrasepsi Implan Levonorgestrel

“…7 Beerthuizen et al dalam penelitian kohort prospektifnya menyatakan bahwa Implanon aman digunakanuntuk wanita muda yang belummencapai peak bone mass, didapatkan bahwa tidak ada hubungan bermakna antara densitas masa tulang dengan kontrasepsi implan dibanding dengan non hormonal. 8 Demikian juga penelitian yang dilakukan olehDi et al, pengukuran densitas tulang pada tulang belakang 2-4 dan proksimal femur tidak secara signifikan mengalami penurunan setelah 12 bulan pemakaian dibandingkan dengan baseline. 9 Berbeda dengan hasil penelitian ini, Pongsatha et al menyatakan bahwa pemakaian implan pada jangka waktu lamamemiliki dampak negatif terhadap densitas tulang pada distal radius dan ulna, namun pada tulang belakangdanfemur tidak didapatkannilai densitas tulang yang tidak normal.…”

Contraceptive Options for the Perimenopausal Woman

“…Pertinent for the perimenopausal patient, this method does not result in a hypoestrogenic state or negatively affect bone mineral density. 37 Similarly to other progestin-only containing contraception, known or suspected pregnancy, current or past history of thrombotic disease, hepatic tumors, active liver disease, undiagnosed abnormal genital bleeding, know, suspected or history of breast cancer and hypersensitivity to any components of the implant are contraindications to this device, if only for the lack of longterm evidence about its use in such populations. 38 Of note, Implanon's predecessor, Norplant, was taken off the U.S. market in 2001 due to concerns over removal.…”