Presented By Samantha KiteRachel AdejohCarla AlpheusSylvia Assiamah
CONTRACEPTIVE METHODSIMPLANTS/INJECTABLES
Implanon - According to Hatcher et al. 2011, currently Implanon is the only single rod implant available in the United States.Norplant and Jadelle- Although has been approved by the FDA. It has not been used in the USA since 2002
TYPES OF IMPLANTS
Description- “ Implanon is a 4cm long and 2mm diameter implant. It contains 68mg of etonogestrel” (Youngkin, 2013).
IMPLANON
The applicator needle is positioned subdermally and the cannula is withdrawn, leaving the implant rod in place between the biceps, and triceps muscle.
APPLICATION
“It suppresses ovulation throughout the fi rst 3 years after insertion”.
“It alters endometrial structures, and it is progestin only”
“It changes cervical mucus, to impede sperm penetration”
(Youngkin, 2013).
MECHANISMS
Youngkin, 2013 reviewed a study which reveals that continued use of implanon in 1 year, yields an eff ective rate of 84%
EFFECTIVENESS
Ease of UseDiscreteNo EstrogenReduces Risk of Ectopic PregnancyReversibleProvides relief for endometriosis associated
symptomsRelief of endometriosis
ADVANTAGES
Abnormal Uterine BleedNo protection against STIsDrug InteractionOvarian CystsUnacceptable bleeding patterns
DISADVANTAGES
<6 weeks Postpartum breast feeding womenCurrent diagnosis of Breast cancerUnexplained, unevaluated abnormal Vaginal bleedingPregnancy
CONTRAINDICATIONS
Informed consentContact clinician for symptoms of infection at the
insertion siteRecord and date when implant should be removedPalpate site after insertion Reversible
PATIENT EDUCATION
Depo-Povera - It is the most commonly used injectable contraceptive. It provides 12 weeks of protection against pregnancy
INJECTABLE
APPLICATION
High effi cacyNo interference with sexHelps to prevent cancer of the uterusDoes not contain estrogen Often decreases bleeding and cramping with periodsEff ective for 12-13 weeks
ADVANTAGES
May cause irregular bleeding (especially in fi rst 6-12 months), light bleeding, or eventually no bleeding
May take up to 9-10 months to resume ovulation/regain fertility after discontinuing use
Long term users may develop temporary and usually reversible decreased bone density. Calcium (1200 mg/day) and vitamin D supplements are recommended while using. May induce weight changes
May cause headachesMay worsen depression No protection from STI's
DISADVANTAGES
Hatcher et al, 2011Youngkin, 2013
REFERENCES