Effectiveness and reasons for discontinuation in Implanon users
in Turkish women
E. Z. Tuzcular Vural, I. Gönenç, N. Aka, G. Köse
Numune Education and Research Hospital, Family Planning Unit, Istanbul, Turkey
Objectives Progestogen-only contraceptive implants are highly effective, easy
to use and reversible methods of contraception . Implanon has been in the
Turkish market since November 2002. We aimed to evaluate the effectiveness and
reasons for discontinuation in women who chose to use Implanon as a
Design and methods Over a period of 38 months, we
performed 110 insertions of Implanon in our family planning unit. All Implanon
users were evaluated for age, educational status, social security status,
occupational status, obstetric history, future family plans, past contraceptive
methods and reasons for Implanon preference prior insertion. The women were
followed-up at the first week and then at 6-month intervals. Complications and
complaints were evaluated and dealt with counselling and/or medical guidance.
Removal requests were evaluated and reasons of discontinuation were noted. Women
were counselled about new methods if they did not want to use implants.
There were a total of 110 insertions and 45 removals.37.8% of the removals were
because the lifespan of the implant had ended.47.1% had new implants inserted
immediately, whereas 17.7% claimed they wanted a new insertion but could not
afford it. Other reasons for discontinuation included bleeding disturbances
(17.8%), depression (13.3%), wish to conceive (11.1%), mastalgia (4.4%) and
gaining weight (4.4%). We had one unintended pregnancy which was terminated on
the user’s request and one difficult removal.
Conclusions Implanon is a
long-acting, effective and safe contraceptive method. It is worth noting that
64.7% of the users in which the lifespan of the implant had ended requested a
new insertion. This shows that with careful counseling and proper user selection,
Implanon will have a significant place in the contraceptive methods list.