Experience with Implanon in a North East London family planning clinic
S. Gupta, K. Rai
Young People and Women’s Service, Hurst Road Health Centre, Walthamstow,
London, UK
Introduction: A retrospective survey of patients’ notes was
conducted to evaluate the long-term contraceptive implant (Implanon) in Waltham
Forest, London.
Objective: To determine continuation rates of this new long-term hormonal
contraceptive.
Results: Of the 142 implants fitted over the 3 year period (February
2000 to January 2003), 132 notes could be retrieved for retrospective analysis.
Of the 132 women, 93% were self-referrals, 5% were from GPs and 2% were from
Secondary care. Preinsertion counselling was undertaken in 97%. The median age
of fitting was 25 years. The most common indications for choosing implants were
choice of a long acting method, suboptimal, compliance with pills or injectables,
bad experience with other methods, associated medical conditions and prior usage
of Norplant. 27 women (20%) required medical intervention for bleeding problems,
in 8 women (30%) bleeding resolved with treatment, 4 women (15%) are continuing
with medical treatment, in 12 women (44%) Implanon was removed due to failure of
bleeding problems to resolve with medical treatment. No pregnancies have been
reported so far based on a follow-up of 85% of women. 15% women were lost to
both virtual and telephonic follow up. 22 implants have been removed by the end
of the study period, with 60% (n=12/22) removals attributed to bleeding problems.
The assumed lifetimes of Implanon using Kaplan Meier method are 0.90 at
12months, 0.80 at 24 months and 0.75 at 35 months. The confirmed life times are
0.84 at 12 months, 0.63 at 24 months and 0.53 at 35 months.
Conclusion: In our experience, Implanon is proving to be a highly
effective, long acting hormonal method of contraception with reasonable
continuation rates at 2 and 3 years. Effective pre and post insertion
counselling is important in patients acceptance of side effects and has an
enormous impact on continuation rates.
