Acceptability and Continuation Rate of Implanon in a Brazilian Public Sector

The main side-effect of Implanon is the changes induces in bleeding patterns including amenorrhea, infrequent to irregular bleeding and frequent and prolonged bleeding; without any previous symptom and it was characterized as "breakthrough bleeding" (BTB). BTB is the main causes of early discontinuations. Unfortunately, there is no indication to predict prior to insertion what sort of bleeding pattern any individual woman may have after insertion and the proposed treatments were disappointed. Nevertheless, previous studies with other progestin-only contraceptives (including Implanon) provide evidence that the provision of adequate and intensive counseling to potential users and new acceptors about bleeding changes can help to improve method continuation.

The availability of Implanon in the public sector could help in the development of strategies to introduce the method in the public sector network and the training of medical residents.

100 women were either allocated to received Implanon contraceptive implant, the LNG-IUS or TCu380A copper-IUD. The women were allocated according to their preference on each of the contraceptive methods.

half of the women will receive the common counseling at the clinic and the other 50% will receive intense counselling about menstrual changes induced by these three contraceptive methods. The continuation rate up to one year will be evaluated through life-table analysis

• Contraceptive Usage
• Bleeding Due to Intrauterine Contraceptive Device

• Device: copper-releasing intrauterine device
  100 women received a 380 mm2 of copper releasing intrauterine device
  Other Name: Optima, Injeflex, Brazil
• Device: ENG-releasing implant
  60 mcg/day releasing etonogestrel implant
  Other Name: Implanion, MSD, Os, The Nedherland
• Device: LNG-releasing intrauterine system
  a LNG-IUS releasing 20 mcd/day of LNG
  Other Name: Mirena, Bayer Oy, Turku, Finland
• Device: LNG-IUS
  100 women will receive an LNG-IUS
  Other Name: Mirena, Bayer Oy, Turku, Finland

• Active Comparator: copper intrauterine device
  100 women will be allocated to receive a TCu380A intrauterine device
  Interventions:

  • Device: copper-releasing intrauterine device
  • Device: ENG-releasing implant
  • Device: LNG-releasing intrauterine system
  • Device: LNG-IUS
• Active Comparator: LNG-releasing intrauterine system
  100 women were allocated to receive a LNG-IUS
  Interventions:

  • Device: ENG-releasing implant
  • Device: LNG-releasing intrauterine system
  • Device: LNG-IUS
• Active Comparator: ENG-releasing implant
  100 women will receive an LNG-IUS
  Interventions:

  • Device: ENG-releasing implant
  • Device: LNG-releasing intrauterine system
  • Device: LNG-IUS

Inclusion Criteria:

• Women 18 to 40 years
• New users of Implanon, IUDs and the LNG-IUS TCu380A

Exclusion Criteria:

• Contraindications to contraceptive methods