Efficacy and safety of a single rod – contraceptive implant (implanon)

Background: Implanon is a subdermal contraceptive implant involves the delivery of a steroid progestin (68 mg of etonogesterel) from a single rod placed under the skin at the inner side of the non-dominant upper arm and the hormone diffuses out slowly at a stable rate providing contraceptive effectiveness for 3 years. Advantages of Implanon includes long term contraceptive action without requiring the user's or provider's attention, low dose of highly effective contraception without use of estrogen and fertility is readily reversible after the removal of implant. Objectives: to assess contraceptive efficacy, safety and acceptability of Implanon. Materials and methods: the study was conducted in Iraq- Al-Samawa and Al- Diwaniya maternity and pediatrics teaching hospital, family planning clinics and privet clinics from the period of October 2012 – October 2014 that includes 41 sexually active women 18-45 years seeking for contraception with normal menstrual cycles, no history of ischemic heart disease or stroke and no history of breast or genital tract malignancy. Results: contraceptive efficacy of Implanon was 98% over 2 years follow up and the most common adverse experience was abnormal bleeding pattern in 100% of women, as amenorrhea affects 51.22%, infrequent bleeding 26.82%,prolonged bleeding 12.20% and metromenorhagia 9.76%.. Discontinuation rate was 2.44% because of menstrual bleeding abnormality. Other adverse experiences after Implanon insertion were weight gain of ≤ 5kg in7.32% after 2 years follow up, acne in 31.71%, mood changes in 21.95% and headache in 12.20%. Conclusions: Implanon is a safe, highly effective and rapidly reversible new method of contraception and the safety profile is acceptable and not essentially different from progestogens in general.