Contraception – Methods – Progesterone Only Implant

  • If an implant is replaced immediately and within 3 years of insertion, there’s no need for additional contraception

Risk/Benefits

  • Progesterone only implant can alleviate dysmennorrhoea
  • No increased risk of stroke/MI/Venous thromboembolic event
  • No evidence for significant reduction in bone mineral density
  • Bleeds
    • less than a quarter have regular bleeds
    • most commonly (about 1 in 3) there’s irregular bleeds
    • one fifth will have no bleeding
    • about a quarter will have prolonged or frequent bleeding
  • Some women do report change in weight / labido / mood theres no proven cause / effect
  • Women may experience improvement/deterioration/new acne symptoms
  • Some reports of headache – no proven association
  • If bleeding is a problem (and excluding other cause), you can use the combined hormonal contraceptive (outside of license) either continuously or cyclically for three months in conjunction with the Progesterone only implant

After removal they need to use other precautions immediately

Factors effecting efficiency

  • enzyme inducing drugs may reduce efficiency
  • so use other methods as well while on those and for 28 days afterwards
  • No problems with obesity
  • Consider replacing it early in obese people

 

In pregnancy

  • The implant is not known to be harmful in pregnancy but if they are going to continue with the pregnancy it’s worth taking it out – if they’re going to terminate then leave it in.