Living comfort at 1 year after placement of subcutaneous etonogestrel
G. Donders, I. Riphagen, T. Van den Bosch
Department of Gynecology, Algemeen Ziekenhuis Tienen, Belgium
The etonogestrel implant contraceptive device (Implanon) was placed in the
upper arm of 188 women in 2001 at the outpatient gynecology clinic of the
general hospital of Tienen, Belgium. Patients were asked to fill out a
questionnaire at placement and again at one year after placement.
Discontinuation of the method was seen in 18%. The main reason of
discontinuation was excessive or irregular vaginal bleeding. Questions about
living comfort in the 145 users returning their questionnaire after one year
showed an increased risk of androgenic side effects and fatigue. On the other
hand, migraine was 16 times less frequent in users (OR 0.06 (0.018–0.21)
p<0.0001), but not other types of headache (Table 1). We conclude that Implanon has disadvantages of irregular bleeding and androgenic side effects, but has a significant improvement on migraines.
Table 1.
Univariate analysis of variables linked to the use of etonogestrel implants |
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Improved | Identical | Worsened | Chi2 or Fisher t statistics | |
Acne | 11 | 78 | 24 | 2.5 (1.2-5.4) p=0.026 |
Libido | 17 | 86 | 19 | |
Mood swings | 16 | 91 | 21 | |
Quality of sleep | 3 | 112 | 13 | 4.7 (1.3-16.9) p=0.018 |
Frequency of urinating | 3 | 119 | 3 | |
Mictalgia | 1 | 95 | 2 | |
Ease of defecation | 4 | 113 | 3 | |
Pleasure to go out | 12 | 103 | 4 | 3.2 (1.0-10.3) p=0.07 |
Migraine | 33 | 63 | 3 | 0.06 (0.02-0.2) p<0.0001 |
Headache (except migraine) | 22 | 71 | 16 | |
Weakness, fatigue | 9 | 63 | 36 | 5.5 (2.5-12.1) p<0.0001 |
Dysmenorrhoea | 43 | 45 | 24 | 0.4 (0.2-0.8) p=0.008 |
Pleasure in sports | 8 | 96 | 10 | |
Pleasure in work | 8 | 100 | 11 | |
Dyspareunia | 7 | 72 | 14 | |
Medication for vaginal yeast infection | 16 | 47 | 8 | |
Medication for vaginal bacterial infection | 13 | 44 | 4 | 3.9 (1.2-12.6) p=0.03 |
Appetite | 19 | 95 | 7 | 3.0 (1.2-7.5) p=0.02 |
Urge to eat chocolates, sweets | 21 | 87 | 19 | |
Greasy hair | 5 | 77 | 28 | 7.2 (2.6-19.4) p<0.001 |
Dry skin | 3 | 92 | 12 | 0.2 (0.06-0.8) p=0.03 |
Breast tenderness | 10 | 73 | 27 | 3.2 (1.5-7.1) p=0.0035 |
Concentration difficulties | 2 | 102 | 11 | 0.2 (0.4-0.8) p=0.019 |
Endurance* | 11 | 85 | 21 |