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Contraceptive Methods Implants/ Injectables. Presented By Samantha Kite Rachel Adejoh Carla Alpheus Sylvia Assiamah. Types of Implants. Implanon - According to Hatcher et al. 2011, currently Implanon is the only single rod implant available in the United States.
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Contraceptive MethodsImplants/Injectables Presented By Samantha Kite Rachel Adejoh Carla Alpheus Sylvia Assiamah
Types of Implants • 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
Implanon Description - “ Implanon is a 4cm long and 2mm diameter implant. It contains 68mg of etonogestrel” (Youngkin, 2013).
Application The applicator needle is positioned subdermally and the cannula is withdrawn, leaving the implant rod in place between the biceps, and triceps muscle.
Mechanisms • “It suppresses ovulation throughout the first 3 years after insertion”. • “It alters endometrial structures, and it is progestin only” • “It changes cervical mucus, to impede sperm penetration” (Youngkin, 2013).
Effectiveness Youngkin, 2013 reviewed a study which reveals that continued use of implanon in 1 year, yields an effective rate of 84%
Advantages • Ease of Use • Discrete • No Estrogen • Reduces Risk of Ectopic Pregnancy • Reversible • Provides relief for endometriosis associated symptoms • Relief of endometriosis
Disadvantages • Abnormal Uterine Bleed • No protection against STIs • Drug Interaction • Ovarian Cysts • Unacceptable bleeding patterns
Contraindications • <6 weeks Postpartum breast feeding women • Current diagnosis of Breast cancer • Unexplained, unevaluated abnormal Vaginal bleeding • Pregnancy
Patient Education • Informed consent • Contact clinician for symptoms of infection at the insertion site • Record and date when implant should be removed • Palpate site after insertion • Reversible
Injectable • Depo-Povera - It is the most commonly used injectable contraceptive. It provides 12 weeks of protection against pregnancy
Advantages • High efficacy • No interference with sex • Helps to prevent cancer of the uterus • Does not contain estrogen • Often decreases bleeding and cramping with periods • Effective for 12-13 weeks
Disadvantages • May cause irregular bleeding (especially in first 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 headaches • May worsen depression • No protection from STI's
References • Hatcher et al, 2011 • Youngkin, 2013