Characteristics and experiences of etonogestrel-releasing contraceptive implant users in a cohort of Turkish women

Yıl 2019, , 34 - 39, 31.03.2019

Demet Kokanalı , Meryem Kuru Pekcan , Yasemin Taşçı

https://doi.org/10.21601/ortadogutipdergisi.501805

Öz

Aim:
To
determine the characteristics and experiences of Etonogestrel-releasing implant
users in Turkish women cohort.

Materials
and Methods: A retrospective cohort study carried out
in a tertiary referral public hospital. The charts of ninety-one women who had Etonogestrel-releasing
implant inserted between January 2014, and April 2016 were reviewed.

Results: Of ninety-one women, over half (52.8 %) were aged ≥ thirty and a
few were < twenty-five (5.5%).
Only three (3.3%) women were nulliparous. Over half were university or higher
graduated (54.9%) and employed (58.2%). Efficacy was the most commonly cited reasons to choose the method. Overall continuation rates were 75.0 % at twenty-five months and 50.0% at thirty-four months. Twenty-nine women removed implant before the period of use expired. Eighteen of these wanted to conceive and the other eleven discontinued because of side effects they experienced. Irregular menstrual bleeding was the most frequent side effect for removal. No woman conceived while using the method.

Conclusion: Etonogestrel-releasing
implant is used for its efficacy by a
range of Turkish women who are especially parous, well-educated and employed.
While it has high continuation rates, irregular menstrual bleeding is the
commonest side effect for early removal.

Anahtar Kelimeler

contraception, etonogestrel, implant

Türk kadın kohortunda etonogestrel salan kontraseptif implant kullanıcılarının özellikleri ve deneyimleri

Öz

Amaç:
Türk kadın kohortunda etonogestrel salan implant kullanıcılarının özelliklerini
ve deneyimlerini belirlemek.

Gereç
ve Yöntemler: Bu retrospektif kohort çalışma,
tersiyer bir referans devlet hastanesinde gerçekleştirildi. Ocak 2014 ile Nisan
2016 arasında Etonogestrel salan implant yerleştirilmiş 91 kadının verileri
gözden geçirildi.

Bulgular:
Doksan bir kadının yarısından fazlası (%52,8) 
≥30 ve birkaçı< 25 (%5,5) yaştaydı. Sadece 3 (%3,3) kadın nullipardı.
Yarısından fazlası universite ve üstü okullardan mezundu (%54,9) ve bir işte çalışmaktaydı
(%58,2). Etkinlik en fazla tercih edilme nedeniydi. Yöntemi kullanmaya devam
etme oranı yirmi beş ayda %75,0 ve otuz dört ayda %50,0 idi. Yirmi dokuz kadın,
kullanım süresi dolmadan implantı çıkardı. Bunların 18'i gebe kalmak istedi ve
diğer 11’i yaşadıkları yan etkiler nedeniyle implant kullanmayı bıraktı.
Düzensiz adet kanaması, en sık görülen yan etkiydi. Bu yöntemi kullanırken
hiçbir kadında gebelik oluşmadı.

Sonuç:
Etonogestrel salan implant, özellikle doğum yapmış, iyi eğitimli ve bir işte
çalışan Türk kadını tarafından etkinliği için kullanılmaktadır. Kullanımına
devam etme oranları yüksek olmasına rağmen, düzensiz adet kanaması erken çıkartma
nedeni olan en sık yan etkisidir.

Anahtar Kelimeler

kontrasepsiyon, etınogestrel, implant

Kaynakça

• 1. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 186 Summary: Long-acting reversible contraception: implants and intrauterine devices. Obstet Gynecol 2017; 130: 1173–75.
• 2. Palomba S, Falbo A, Di Cello A, Materazzo C, Zullo F. Nexplanon: the new implant for long-term contraception. A comprehensive descriptive review. Gynecol Endocrinol 2012; 28: 710-21.
• 3. Darney P, Patel A, Rosen K, Shapiro LS, Kaunitz AM. Safety and efficacy of a single-rod etonogestrel implant (Implanon): Results from 11 international clinical trials. Fertil Steril 2009; 91: 1646–53.
• 4. Beerthuizen R. Safety and efficacy of the subdermal etonogestrel contraceptive implant Implanon. J Fam Plann Reprod Health Care 2017; 43: 118.
• 5. Kabir A, Bidia F, Beth F, et al. Contraceptive commodities for women’s health. Hormonal implants: repared for the United Nations Commission on Life-Saving Commodities for Women and Children. 2012 March.
• 6. Collumbien M, Gerressu M, Cleland J. Non-use and use of ineffective methods of contraception. In: Ezzati M, Lopez AD, Rodgers A, Murray CJL, (eds). Comparative quantification of health risks: the global and regional burden of disease attributable to selected major risk factors. Geneva: World Health Organization; 2004:1255–319
• 7. Schivone GB, Blumenthal PD. Contraception in the developing world: special considerations. Semin Reprod Med 2016; 34: 168-74.
• 8. Türkiye Nüfus ve Sağlık araştırması 2013. Available from: http://www.hips.hacettepe.edu.tr/tnsa2013/rapor/TNSA_2013_ana_rapor.pdf. Accessed in 2018 (May 25).
• 9. Gebre-Egziabher D, Medhanyie AA, Alemayehu M, Tesfay FH. Prevalence and predictors of implanon utilization among women of reproductive age group in Tigray Region, Northern Ethiopia. Reprod Health 2017; 14: 62.
• 10. Cea Soriano L, Wallander M-A, Andersson S, Filonenko A, García Rodríguez LA. Use of long-acting reversible contraceptives in the UK from 2004 to 2010: analysis using the health improvement network database. Eur J Contracept Reprod Health Care 2014; 19: 439–47.
• 11. Steinauer JE, Upadhyay UD, Sokoloff A, et al. Choice of the levonorgestrel intrauterine device, etonogestrel implant or depot medroxyprogesterone acetate for contraception after aspiration abortion. Contraception. 2015; 92: 553-559.
• 12. Palamuleni ME. Socio-economic and demographic factors affecting contraceptive use in Malawi. Afr J Reprod Health. 2013; 17: 91–104.
• 13. Bateson D, Harvey C, Trinh L, Stewart M, Black KI. User characteristics, experiences and continuation rates of copper intrauterine device use in a cohort of Australian women. Aust N Z J Obstet Gynaecol 2016; 56 :655-61.
• 14. Pam VC, Mutihir JT, Nyango DD, et al. Sociodemographic profiles and use-dynamics of Jadelle (levonorgestrel) implants in Jos, Nigeria. Niger Med J 2016; 57: 314-19.
• 15. Takele A, Degu G, Yitayal M. Demand for long acting and permanent methods of contraceptives and factors for non-use among married women of Goba Town, Bale Zone, South East Ethiopia. Reprod Health 2012; 9: 26.
• 16. Teunissen AM, Grimm B, Roumen FJ. Continuation rates of the subdermal contraceptive Implanon(®) and associated influencing factors. Eur J Contracept Reprod Health Care 2014; 19: 15-21.
• 17. Law A, Liao L, Lin J, Yaldo A, Lynen R. Twelve-month discontinuation rates of levonorgestrel intrauterine system 13.5 mg and subdermal etonogestrel implant in women aged 18-44: a retrospective claims database analysis. Contraception 2018 Apr 21; 7824(18)30142-2.
• 18. Harvey C, Seib C, Lucke J. Continuation rates and reasons for removal among Implanon users accessing two family planning clinics in Queensland, Australia. Contraception 2009; 80: 527-32.
• 19. National Collaborating Centre for Women's and Children's Health. Long-acting reversible contraception: the effective and appropriate use of long-acting reversible contraception. London: RCOG Press; 2005. Commissioned by the National Institute for Health and Clinical Excellence.
• 20. Blumenthal PD, Gemzell-Danielsson K, Marintcheva-Petrova M. Tolerability and clinical safety of Implanon. Eur J Contracept Reprod Health Care 2008;13: 29-36.
• 21. Jeffreys LA, Clark AL. A successful approach to long-acting contraceptive implants in primary care. Contraception 2012; 85: 381-83.
• 22. Casey PM, Long ME, Marnach ML, Bury JE. Bleeding related to etonogestrel subdermal implant in a US population. Contraception 2011; 83: 426-30.
• 23. Mommers E, Blum GF, Gent TG, et al. Nexplanon, a radiopaque etonogestrel implant in combination with a next-generation applicator: 3-year results of a noncomparative multicenter trial. Am J Obstet Gynecol 2012; 207: 388.
• 24. Ezegwui HU, Ikeako LC, Ishiekwene CI, Oguanua TC. The discontinuation rate and reasons for discontinuation of Implanon at the family planning clinic of University of Nigeria Teaching Hospital (UNTH) Enugu, Nigeria. Niger J Med 2011; 20: 448-50.
• 25. Weisberg E, Fraser I. Australian women's experience with Implanon. Aust Fam Physician 2005; 34: 694-96.
• 26. Rubenstein J, Rubenstein P, Barter J, Pittrof R. Counselling styles and their effect on subdermal contraceptive implant continuation rates. Eur J Contracept Reprod Health Care. 2011; 16: 225-28.