Progesterone Only Implant

Question 1

What are the 3 methods of progestogen only contraception?

Answer 1

Progestogen-only method of contraception:

1. Progestogen-only pill
2. Progestogen-only implant
3. Progestogen-only injection

Question 2

Briefly describe the mechanism of action of the progestogen-only implant

Answer 2

Prevents pregnancy by inhibiting ovulation. It also causes changes in cervical mucus that inhibit sperm. Serum etonogestrel concentrations rise rapidly after insertion of the implant and ovulation is likely to be inhibited within 24 hours.

Question 3

What is the most common regime for progestogen-only implant?

Answer 3

• Must only be inserted by healthcare professionals who have been appropriately trained and accredited.
• Insert the progestogen-only implant up to, and including day 5 of the menstrual cycle.
• Can last up to 3 years.

Question 4

What are the indications for progesterone-only implant?

Answer 4

• Contraception for women in whom estrogen-containing contraceptives are contraindicated

Question 5

What are the advantages of progesterone-only implant?

Answer 5

• The implant is very effective
• Users do not have to think about contraception for 3 years
• Sexual intercourse need not be interrupted to use the implant
• It can be used when breastfeeding.
• Normal fertility returns as soon as the implant is removed
• It can be used in women for whom combined hormonal contraceptives are not recommended
• It may help alleviate dysmenorrhoea
• It may reduce the risk of endometrial cancer.
• It is not associated with many serious adverse effects
• It is effective in women of all weights

Question 6

What are the disadvantages of progesterone-only implant?

Answer 6

• About 50% of women will experience changes in menstrual bleeding, and bleeding patterns are likely to remain irregular
• Contraceptive efficacy is likely to be reduced in women using liver enzyme-inducing drugs
• An implant does not protect against sexually transmitted infections (STIs)

Question 7

What are the side effects of progesterone-only implant?

Answer 7

• Menstrual irregularities
• Acne

Question 8

What are the risks of progesterone-only implant?

Answer 8

• Complication of insertion and removal
• Breast cancer

Question 9

What is the efficacy of progesterone-only implant?

Answer 9

• Progesterone-only implant used perfectly (consistently and correctly)→ 0.05% of women will conceive within the first year of use due to method failure

Question 10

What contra-indications are associated with the progesterone-only implant?

Answer 10

• Breast cancer
• Acute porphyrias

Question 11

Briefly describe the assessment for POPs

Answer 11

• Check the UK Medical Eligibility Criteria
• Check the woman’s cervical screening history to ensure that she has attended routine screening appointments