etonogestrel implant Flashcards
what is the etonogestrel implant
small subdermal ethylene vinyl acetate rod (eg. implanon NXT)
progestogen only long acting reversible contraceptice
how does it work
thickens cervical mucous and suppresses ovulation
can be used as first line option in famales of all ages
contraindications of etonogestrel implant
current breast cancer
can implanon be used in people with history of VTE
yes - generally safe in people with history of IHD, cerebrovascular disease or VTE
use of etonogestrel implant requires judgemeent in those with
unexplained vaginal bleeding before investigation of the cause
past breast cancer
severe cirrhosis
hepatocellularr adenoma or malignant liver tumour
IHD, stroke or TIAs developing during use
advantages of implanon
extremely effective 99.95%
minimal user involvement
effective for three years
high continuation rates
cost effective
no adverse effect on bone mineral density, can be used for adolescents and perimenopausal people
suitable for quickstart
useful alternative when oestrogen is contraindicated
induces amenorrhea in 22% of users
may improve dysmenorrhea
can implanon be used while breast feeding
safe to use immidiately post partum and during breastfeeding
how soon is ovulation restored after removal of implanon
restored within weeks of removal
cost of implanon
available on PBS but cost of insertion varies with provider
disadvantages of implanon
altered bleeding patterns
requires procedure for insertion
deep insertion can result in implant migration
scarring at implant site
drug interactions
benign ovarian cysts
other adverse effects: headaches, mood changes, weight gain, breast tenderness, loss of libido
when can etonogestrel implants be inserted
at any time during the menstrual cycle
suitable for quickstart
if pregnancy cannot be excluded, follow up pregnancy test is advised 4 weeks after insertion, or 3 weeks if no further episodes of unprotected sex occured in the first week of use
implanon is immediately effective if
inserted day 1-5 of a regular cycle
inserted less than 21 days post-partum
inserted within 5 days of an abortion
replacing an etonogestrel implant
switching from depot injections
switching from copper IUD during days 1-5 of regular menstrual cycle
takes 7 days to become effective at all other times
recommended site of insertion
over the triceps