Top

Current Obstetrics and Gynecology Reports

Published in:

01-03-2015 | Family Planning (A Burke, Section Editor)

The Contraceptive Implant: An Updated Review of the Evidence

Authors: Jennifer Amico, Bhavik Kumar, Hilary Rosenstein, Marji Gold

Published in: Current Obstetrics and Gynecology Reports | Issue 1/2015

Abstract

The etonogestrel implant is a form of highly effective and long-acting reversible contraception, available in the U.S. as Nexplanon® (Merck and Co, Inc., Kenilworth, NJ, U.S.). It is placed under the skin of the upper arm by health care providers and is approved for use up to 3 years. It is more effective than any other method, including the intrauterine devices (IUDs) and permanent sterilization methods. It has few contraindications, and has high rates of satisfaction and continuation. While irregular bleeding is the most common side effect and reason for discontinuation of the method, most women experience reduced bleeding overall, and it can be used to improve dysmenorrhea, menorrhagia, and endometriosis. Complications related to use, insertion, and removal are rare. While the implant has many advantages, it is important for providers of family planning to use a patient-centered approach to counseling about all contraceptives, including highly effective reversible methods, and to support women’s reproductive autonomy.

Croxatto HB. Mechanisms that explain the contraceptive action of progestin implants for women. Contraception. 2002;65(1):21–7.CrossRefPubMed

Wenzl R, van Beek A, Schnabel P, Huber J. Pharmacokinetics of etonogestrel released from the contraceptive implant Implanon. Contraception. 1998;58(5):283–8.CrossRefPubMed

3.•

Schnabel P, Merki-Feld GS, Malvy A, Duijkers I, Mommers E, van den Heuvel MW. Bioequivalence and x-ray visibility of a radiopaque etonogestrel implant versus a non-radiopaque implant: a 3-year, randomized, double-blind study. Clin Drug Investig. 2012;32(6):413–22. This study demonstrates that the addition of barium to the etonogestrel implant allowed it to become visible on x-ray while maintaining bioequivalence to the non-radiopaque implant.CrossRefPubMed

4.•

Mommers E, Blum GF, Gent TG, Peters KP, Sordal TS, Marintcheva-Petrova M. Nexplanon, a radiopaque etonogestrel implant in combination with a next-generation applicator: 3-year results of a noncomparative multicenter trial. Am J Obstet Gynecol. 2012;207(5):388 e1–6. This study demonstrates safety of the radiopaque implant, with no deep insertions and a low complication rate.CrossRef

CDC. US Medical Eligibility Criteria for Contraceptive Use, 2010. Adapted from the World Health Organization Medical Eligibility Criteria for Contraceptive Use, 4th edition. MMWR. 2010;59:1–84.

Finer LB, Jerman J, Kavanaugh ML. Changes in use of long-acting contraceptive methods in the United States, 2007–2009. Fertil Steril. 2012;98(4):893–7.CrossRefPubMedCentralPubMed

Peipert JF, Zhao Q, Allsworth JE, Petrosky E, Madden T, Eisenberg D, et al. Continuation and satisfaction of reversible contraception. Obstet Gynecol. 2011;117(5):1105–13.CrossRefPubMedCentralPubMed

Watkins ES. From breakthrough to bust: the brief life of Norplant, the contraceptive implant. J Wom Hist. 2010;22(3):88–111.CrossRef

Davies GC, Feng LX, Newton JR, Van Beek A, Coelingh-Bennink HJ. Release characteristics, ovarian activity and menstrual bleeding pattern with a single contraceptive implant releasing 3-ketodesogestrel. Contraception. 1993;47(3):251–61.CrossRefPubMed

10.

Makarainen L, van Beek A, Tuomivaara L, Asplund B, Bennink CH. Ovarian function during the use of a single contraceptive implant: Implanon compared with Norplant. Fertil Steril. 1998;69(4):714–21.CrossRefPubMed

11.

Hatcher RA, Trussell J, Nelson AL, Cates W, Stewart F. Contraceptive Technology. 19th ed. New York: Ardent Media; 2008.

12.

Darney P, Patel A, Rosen K, Shapiro LS, Kaunitz AM. Safety and efficacy of a single-rod etonogestrel implant (Implanon): results from 11 international clinical trials. Fertil Steril. 2009;91(5):1646–53.CrossRefPubMed

13.

Trussell J. Contraceptive failure in the United States. Contraception. 2011;83(5):397–404.CrossRefPubMedCentralPubMed

14.•

Winner B, Peipert JF, Zhao Q, Buckel C, Madden T, Allsworth JE, et al. Effectiveness of long-acting reversible contraception. New Engl J Med. 2012;366(21):1998–2007. This large study demonstrates the superior effectiveness of long acting contraceptive methods over shorter acting methods.CrossRefPubMed

15.

Zheng SR, Zheng HM, Qian SZ, Sang GW, Kaper RF. A randomized multicenter study comparing the efficacy and bleeding pattern of a single-rod (Implanon) and a six-capsule (Norplant) hormonal contraceptive implant. Contraception. 1999;60(1):1–8.CrossRefPubMed

16.

Graesslin O, Korver T. The contraceptive efficacy of Implanon: a review of clinical trials and marketing experience. Eur J Contracept Reprod Health Care. 2008;13 Suppl 1:4–12.CrossRefPubMed

17.

Funk S, Miller MM, Mishell Jr DR, Archer DF, Poindexter A, Schmidt J, et al. Safety and efficacy of Implanon, a single-rod implantable contraceptive containing etonogestrel. Contraception. 2005;71(5):319–26.CrossRefPubMed

18.

Flores JB, Balderas ML, Bonilla MC, Vazquez-Estrada L. Clinical experience and acceptability of the etonogestrel subdermal contraceptive implant. Int J Gynaecol Obstet. 2005;90(3):228–33.CrossRefPubMed

19.

Harrison-Woolrych M, Hill R. Unintended pregnancies with the etonogestrel implant (Implanon): a case series from postmarketing experience in Australia. Contraception. 2005;71(4):306–8.CrossRefPubMed

20.

Bennink HJ. The pharmacokinetics and pharmacodynamics of Implanon, a single-rod etonogestrel contraceptive implant. Eur J Contracept Reprod Health Care. 2000;5 Suppl 2:12–20.PubMed

21.

Mornar S, Chan LN, Mistretta S, Neustadt A, Martins S, Gilliam M. Pharmacokinetics of the etonogestrel contraceptive implant in obese women. Am J Obstet Gynecol. 2012;207(2):110 e1–6.CrossRef

22.

Lopez LM, Grimes DA, Chen M, Otterness C, Westhoff C, Edelman A, et al. Hormonal contraceptives for contraception in overweight or obese women. Cochrane Database Syst Rev. 2013;4:CD008452.PubMed

23.•

Xu H, Wade JA, Peipert JF, Zhao Q, Madden T, Secura GM. Contraceptive failure rates of etonogestrel subdermal implants in overweight and obese women. Obstet Gynecol. 2012;120(1):21–6. This large study demonstrates that the implant does not lose effectiveness in overweight or obese women.CrossRefPubMedCentralPubMed

24.

Merck Pharmaceuticals. (2001, revised 7/2014). Nexplanon: highlights of prescribing information. Retrieved from http://www.merck.com/product/usa/pi_circulars/n/nexplanon/nexplanon_pi.pdf.

25.

Kiriwat O, Patanayindee A, Koetsawang S, Korver T, Bennink HJ. A 4-year pilot study on the efficacy and safety of Implanon, a single-rod hormonal contraceptive implant, in healthy women in Thailand. Eur J Contracept Reprod Health Care. 1998;3(2):85–91.CrossRefPubMed

26.

Affandi B, Korver T, Geurts TB, Coelingh Bennink HJ. A pilot efficacy study with a single-rod contraceptive implant (Implanon) in 200 Indonesian women treated for < or = 4 years. Contraception. 1999;59(3):167–74.CrossRefPubMed

27.

Cea Soriano L, Wallander MA, Andersson S, Filonenko A, Garcia Rodriguez LA. The continuation rates of long-acting reversible contraceptives in UK general practice using data from The Health Improvement Network. Pharmacoepidemiol Drug Saf. 2015;24(1):52–8.

28.•

O'Neil-Callahan M, Peipert JF, Zhao Q, Madden T, Secura G. Twenty-four-month continuation of reversible contraception. Obstet Gynecol. 2013;122(5):1083–91. This large study demonstrates that the high continuation of LARC methods persists to 24 months after starting the methods, and remains much higher than shorter-acting methods.CrossRefPubMed

29.

Teunissen AM, Grimm B, Roumen FJ. Continuation rates of the subdermal contraceptive Implanon((R)) and associated influencing factors. Eur J Contracept Reprod Health Care. 2014;19(1):15–21.CrossRefPubMed

30.

Weisberg E, Bateson D, McGeechan K, Mohapatra L. A three-year comparative study of continuation rates, bleeding patterns and satisfaction in Australian women using a subdermal contraceptive implant or progestogen releasing-intrauterine system. Eur J Contracept Reprod Health Care. 2014;19(1):5–14.CrossRefPubMed

31.

Wilson S, Tennant C, Sammel MD, Schreiber C. Immediate postpartum etonogestrel implant: a contraception option with long-term continuation. Contraception. 2014;90(3):259–64.CrossRefPubMed

32.

Grunloh DS, Casner T, Secura GM, Peipert JF, Madden T. Characteristics Associated With Discontinuation of Long-Acting Reversible Contraception Within the First 6 Months of Use. Obstet Gynecol. 2013;122:1214–21.CrossRefPubMed

33.

Short M, Dallay D, Omokanye S, Stauch K, Inki P. Acceptability of long-acting, progestin-only contraception in Europe: a two-year prospective, non-interventional study. Eur J Contracept Reprod Health Care. 2014;19(1):29–38.CrossRefPubMed

34.

Ireland LD, Goyal V, Raker CA, Murray A, Allen RH. The effect of immediate postpartum compared to delayed postpartum and interval etonogestrel contraceptive implant insertion on removal rates for bleeding. Contraception. 2014;90(3):253–8.CrossRefPubMed

35.

Madden T, Eisenberg DL, Zhao Q, Buckel C, Secura GM, Peipert JF. Continuation of the etonogestrel implant in women undergoing immediate postabortion placement. Obstet Gynecol. 2012;120(5):1053–9.PubMedCentralPubMed

36.

Mark A, Sonalkar S, Borgatta L. One-year continuation of the etonogestrel contraceptive implant in women with postabortion or interval placement. Contraception. 2013;88(5):619–23.CrossRefPubMed

37.

Diedrich JT, Desai S, Zhao Q, Secura G, Madden T, Peipert JF. Association of short-term bleeding and cramping patterns with long-acting reversible contraceptive method satisfaction. Am J Obstet Gynecol. 2015;212(1):50.e1–8.

38.

ACOG. ACOG Committee Opinion no. 450: Increasing use of contraceptive implants and intrauterine devices to reduce unintended pregnancy. American College of Obstetricians and Gynecologists, Committee on Gynecologic Practice, and Long-Acting Reversible Contraception Working Group. Obstet Gynecol. 2009;114(6):1434–8.

39.•

ACOG. ACOG Committee Opinion no. 539: Adolescents and long-acting reversible contraception: implants and intrauterine devices. The American College of Obstetricians and Gynecologists, Committee on Adolescent Health Care, and Long-Acting Reversible Contraception Working Group. Obstet Gynecol. 2012;120(4):983–8. This committee opinion expresses that not only are adolescents good candidates for implants and IUDs, but because of their safety and many advantages, they should be offered first line.

40.

Centers for Disease Control and Prevention. Selected Practice Recommendations for Contraceptive Use, 2013. Adapted from the World Health Organization Selected Practice Recommendations for Contraceptive Use, 2nd edition. MMWR, 2010;62:1–46.

41.

Davis D. Review prepared for the FDA in 2001. Teratogenic Risk of Hormonal Products for Contraception: A Review of the Literature, http://www.fda.gov/ohrms/dockets/ac/03/briefing/4015B1_14_FDATab5-3-TeratogenReview.pdf. Accessed August 30, 2014.

42.

Levine JP, Sinofsky FE, Christ MF, Implanon USSG. Assessment of Implanon insertion and removal. Contraception. 2008;78(5):409–17.CrossRefPubMed

43.

ACOG Practice Bulletin No. 110: noncontraceptive uses of hormonal contraceptives. Obstet Gynecol. 2010;115(1):206–18

44.

Mansour D, Korver T, Marintcheva-Petrova M, Fraser IS. The effects of Implanon on menstrual bleeding patterns. Eur J Contracept Reprod Health Care. 2008;13 Suppl 1:13–28.CrossRefPubMed

45.

Casey PM, Long ME, Marnach ML, Bury JE. Bleeding related to etonogestrel subdermal implant in a US population. Contraception. 2011;83(5):426–30.CrossRefPubMed

46.

Walch K, Unfried G, Huber J, Kurz C, van Trotsenburg M, Pernicka E, et al. Implanon versus medroxyprogesterone acetate: effects on pain scores in patients with symptomatic endometriosis–a pilot study. Contraception. 2009;79(1):29–34.CrossRefPubMed

47.

Surrey ES. The role of progestins in treating the pain of endometriosis. J Minim Invasive Gynecol. 2006;13(6):528–34.CrossRefPubMed

48.

Shokeir T, Amr M, Abdelshaheed M. The efficacy of Implanon for the treatment of chronic pelvic pain associated with pelvic congestion: 1-year randomized controlled pilot study. Arch Gynecol Obstet. 2009;280(3):437–43.CrossRefPubMed

49.

Zheng SR, Zheng HM, Qian SZ, Sang GW, Kaper RF. A long-term study of the efficacy and acceptability of a single-rod hormonal contraceptive implant (Implanon) in healthy women in China. Eur J Contracept Reprod Health Care. 1999;4(2):85–93.CrossRefPubMed

50.

Deokar AM, Jackson W, Omar HA. Menstrual bleeding patterns in adolescents using etonogestrel (ENG) implant. Int J Adolesc Med Health. 2011;23(1):75–7.CrossRefPubMed

51.

Casey PM, Long ME, Marnach ML, Fleming-Harvey J, Drozdowicz LB, Weaver AL. Association of body mass index with removal of etonogestrel subdermal implant. Contraception. 2013;87(3):370–4.CrossRefPubMed

52.

Mansour D, Bahamondes L, Critchley H, Darney P, Fraser IS. The management of unacceptable bleeding patterns in etonogestrel-releasing contraceptive implant users. Contraception. 2011;83(3):202–10.CrossRefPubMed

53.

Abdel-Aleem H, d'Arcangues C, Vogelsong KM, Gaffield ML, Gulmezoglu AM. Treatment of vaginal bleeding irregularities induced by progestin only contraceptives. Cochrane Database Syst Rev. 2013;10:CD003449.PubMed

54.

Casey PM, Long ME, Drozdowicz LB, Marnach ML, Weaver AL. Management of etonogestrel subdermal implant-related bleeding. J Reprod Med. 2014;59(5–6):306–12.PubMed

55.

Halpern V, Lopez LM, Grimes DA, Gallo MF. Strategies to improve adherence and acceptability of hormonal methods of contraception. Cochrane Database Syst Rev. 2011;4:CD004317.PubMed

56.

Lopez LM, Edelman A, Chen M, Otterness C, Trussell J, Helmerhorst FM. Progestin-only contraceptives: effects on weight. Cochrane Database Syst Rev. 2013;7:CD008815.PubMed

57.

Vickery Z, Madden T, Zhao Q, Secura GM, Allsworth JE, Peipert JF. Weight change at 12 months in users of three progestin-only contraceptive methods. Contraception. 2013;88(4):503–8.CrossRefPubMedCentralPubMed

58.

Nault AM, Peipert JF, Zhao Q, Madden T, Secura GM. Validity of perceived weight gain in women using long-acting reversible contraception and depot medroxyprogesterone acetate. Am J Obstet Gynecol. 2013;208(1):48 e1–8.CrossRef

59.

Seven A, Yuksel B, Kilic S, Esen H, Keskin U, Ulubay M, et al. Effect of injectable medroxyprogesterone acetate and etonogestrel implants on GABA-A and serotonin receptors in white and gray matter of the brain: experimental study in rats. Gynecol Endocrinol. 2014;30(4):320–4.CrossRefPubMed

60.

Kapp N, Curtis K, Nanda K. Progestogen-only contraceptive use among breastfeeding women: a systematic review. Contraception. 2010;82(1):17–37.CrossRefPubMed

61.

Bahamondes L, Bahamondes MV, Modesto W, Tilley IB, Magalhaes A, Pinto e Silva JL, et al. Effect of hormonal contraceptives during breastfeeding on infant's milk ingestion and growth. Fertil Steril. 2013;100(2):445–50.CrossRefPubMed

62.

Gurtcheff SE, Turok DK, Stoddard G, Murphy PA, Gibson M, Jones KP. Lactogenesis after early postpartum use of the contraceptive implant: a randomized controlled trial. Obstet Gynecol. 2011;117(5):1114–21.CrossRefPubMed

63.

Lopez LM, Grimes DA, Schulz KF, Curtis KM, Chen M. Steroidal contraceptives: effect on bone fractures in women. Cochrane Database Syst Rev. 2014;6:CD006033.PubMed

64.

Pongsatha S, Ekmahachai M, Suntornlimsiri N, Morakote N, Chaovisitsaree S. Bone mineral density in women using the subdermal contraceptive implant Implanon for at least 2 years. Int J Gynaecol Obstet. 2010;109(3):223–5.CrossRefPubMed

65.

Bahamondes L, Monteiro-Dantas C, Espejo-Arce X, Dos Santos Fernandes AM, Lui-Filho JF, Perrotti M, et al. A prospective study of the forearm bone density of users of etonorgestrel- and levonorgestrel-releasing contraceptive implants. Hum Reprod. 2006;21(2):466–70.CrossRefPubMed

66.

Monteiro-Dantas C, Espejo-Arce X, Lui-Filho JF, Fernandes AM, Monteiro I, Bahamondes L. A three-year longitudinal evaluation of the forearm bone density of users of etonogestrel- and levonorgestrel-releasing contraceptive implants. Reprod Health. 2007;4:11.CrossRefPubMedCentralPubMed

67.

World Health Organization Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Cardiovascular disease and use of oral and injectable progestogen-only contraceptives and combined injectable contraceptives. Results of an international, multicenter, case-control study. Contraception. 1998;57(5):315–24.

68.

Heinemann LA, Assmann A, DoMinh T, Garbe E. Oral progestogen-only contraceptives and cardiovascular risk: results from the Transnational Study on Oral Contraceptives and the Health of Young Women. Eur J Contracept Reprod Health Care. 1999;4(2):67–73.CrossRefPubMed

69.

Vasilakis C, Jick H, Del Mar Melero-Montes M. Risk of idiopathic venous thromboembolism in users of progestagens alone. Lancet. 1999;354(9190):1610–1.CrossRefPubMed

70.

Brito MB, Ferriani RA, Meijers JC, Garcia AA, Quintana SM, Silva de Sa MF. Effects of the etonogestrel-releasing contraceptive implant inserted immediately postpartum on maternal hemostasis: a randomized controlled trial. Thromb Res. 2012;130(3):355–60.CrossRefPubMed

71.

Inal MM, Yildirim Y, Ertopcu K, Avci ME, Ozelmas I, Tinar S. Effect of the subdermal contraceptive etonogestrel implant (Implanon) on biochemical and hormonal parameters (three years follow-up). Eur J Contracept Reprod Health Care. 2008;13(3):238–42.CrossRefPubMed

72.

Merki-Feld GS, Imthurn B, Seifert B. Effects of the progestagen-only contraceptive implant Implanon on cardiovascular risk factors. Clin Endocrinol. 2008;68(3):355–60.

73.

Taheri M, Rahimi M, Naderi M, Ghavami S, Mokhtari M, Rashidi H, et al. Effects of a subdermal levonorgestrel contraceptive implant (Norplant) on serum cholesterol, triglycerides, ALT and AST in Iranian women. Contraception. 2006;73(1):56–8.CrossRefPubMed

74.

Blumenthal PD, Gemzell-Danielsson K, Marintcheva-Petrova M. Tolerability and clinical safety of Implanon. Eur J Contracept Reprod Health Care. 2008;13 Suppl 1:29–36.CrossRefPubMed

75.

Egberg N, van Beek A, Gunnervik C, Hulkko S, Hirvonen E, Larsson-Cohn U, et al. Effects on the hemostatic system and liver function in relation to Implanon and Norplant. Prospect Random Clin Trial Contracept. 1998;58(2):93–8.

76.

Hernandez-Juarez J, Garcia-Latorre EA, Moreno-Hernandez M, Moran-Perez JF, Rodriguez-Escobedo MA, Cogque-Hernandez G, et al. Metabolic effects of the contraceptive skin patch and subdermal contraceptive implant in Mexican women: a prospective study. Reprod Health. 2014;11:33.CrossRefPubMedCentralPubMed

77.

Brache V, Faundes A, Alvarez F, Cochon L. Nonmenstrual adverse events during use of implantable contraceptives for women: data from clinical trials. Contraception. 2002;65(1):63–74.CrossRefPubMed

78.

Osman N, Mirlesse V. A new complication of contraceptive hormonal implant: about two cases of lesions of the ulnar nerve at the arm level. Gynecol Obstet Fertil. 2005;33(5):322–5.CrossRefPubMed

79.

Brown M, Britton J. Neuropathy associated with etonogestrel implant insertion. Contraception. 2012;86(5):591–3.CrossRefPubMed

80.

Agrawal A, Robinson C. Spontaneous snapping of an Implanon in two halves in situ. J Fam Plann Reprod Health Care Fac Fam Plan Reprod Health Care Roy Coll Obstet Gynaecol. 2003;29(4):238.CrossRef

81.

Croxatto HB, Urbancsek J, Massai R, Coelingh Bennink H, van Beek A. A multicentre efficacy and safety study of the single contraceptive implant Implanon. Implanon Study Group. Hum Reprod. 1999;14(4):976–81.CrossRefPubMed

82.

Ismail H, Mansour D, Singh M. Migration of Implanon. J Fam Plan Reprod Health Care Fac Fam Plan Reprod Health CareRoy Coll Obstet Gynaecol. 2006;32(3):157–9.CrossRef

83.

Vidin E, Garbin O, Rodriguez B, Favre R, Bettahar-Lebugle K. Removal of etonogestrel contraceptive implants in the operating theater: report on 28 cases. Contraception. 2007;76(1):35–9.CrossRefPubMed

84.

Brown SS, Burdette L, Rodriguez P. Looking inward: provider-based barriers to contraception among teens and young adults. Contraception. 2008;78(5):355–7.CrossRefPubMed

85.

Goodman S, Hendlish SK, Benedict C, Reeves MF, Pera-Floyd M, Foster-Rosales A. Increasing intrauterine contraception use by reducing barriers to post-abortal and interval insertion. Contraception. 2008;78(2):136–42.CrossRefPubMed

86.

Speidel JJ, Harper CC, Shields WC. The potential of long-acting reversible contraception to decrease unintended pregnancy. Contraception. 2008;78(3):197–200.CrossRefPubMed

87.

Dehlendorf C, Levy K, Ruskin R, Steinauer J. Health care providers' knowledge about contraceptive evidence: a barrier to quality family planning care? Contraception. 2010;81(4):292–8.CrossRefPubMedCentralPubMed

88.

Greenberg KB, Makino KK, Coles MS. Factors associated with provision of long-acting reversible contraception among adolescent health care providers. J Adolesc Health. 2013;52(3):372–4.CrossRefPubMedCentralPubMed

89.

Herbitter C, Greenberg M, Fletcher J, Query C, Dalby J, Gold M. Family planning training in US family medicine residencies. Fam Med. 2011;43(8):574–81.PubMed

90.

Trussell J, Henry N, Hassan F, Prezioso A, Law A, Filonenko A. Burden of unintended pregnancy in the United States: potential savings with increased use of long-acting reversible contraception. Contraception. 2013;87(2):154–61.

91.

Peipert JF, Madden T, Allsworth JE, Secura GM. Preventing unintended pregnancies by providing no-cost contraception. Obstet Gynecol. 2012;120(6):1291–7.PubMedCentralPubMed

92.

Foster DG, Rostovtseva DP, Brindis CD, Biggs MA, Hulett D, Darney PD. Cost savings from the provision of specific methods of contraception in a publicly funded program. Am J Publ Health. 2009;99(3):446–51.CrossRef

93.

Baldwin MK, Edelman AB. The effect of long-acting reversible contraception on rapid repeat pregnancy in adolescents: a review. J Adolesc Health. 2013;52(4 Suppl):S47–53.CrossRefPubMed

94.

Tocce KM, Sheeder JL, Teal SB. Rapid repeat pregnancy in adolescents: do immediate postpartum contraceptive implants make a difference? Am J Obstet Gynecol. 2012;206(6):481 e1–7.CrossRef

95.

Kavanaugh ML, Jerman J, Ethier K, Moskosky S. Meeting the contraceptive needs of teens and young adults: youth-friendly and long-acting reversible contraceptive services in u.s. Family planning facilities. J Adolesc Health. 2013;52(3):284–92.CrossRefPubMed

96.

Gilliam ML, Martins SL, Bartlett E, Mistretta SQ, Holl JL. Development and testing of an iOS waiting room "app" for contraceptive counseling in a Title X family planning clinic. Am J Obstet Gynecol. 2014;211:481.e1–8.CrossRef

97.•

Higgins JA. Celebration meets caution: LARC's boons, potential busts, and the benefits of a reproductive justice approach. Contraception. 2014;89(4):237–41. This commentary remarks that while the LARC methods have many advantages, it is important for family planning providers to maintain a reproductive justice approach when providing contraception. Otherwise, it is possible for these methods to be overly emphasized with great cost to women's reproductive autonomy, particularly women of color or low socioeconomic status.CrossRefPubMed

98.

Dehlendorf C, Ruskin R, Grumbach K, Vittinghoff E, Bibbins-Domingo K, Schillinger D, et al. Recommendations for intrauterine contraception: a randomized trial of the effects of patients' race/ethnicity and socioeconomic status. Am J Obstet Gynecol. 2010;203(4):319 e1–8.CrossRef

99.•

Hoggart L, Newton VL, Dickson J. "I think it depends on the body, with mine it didn't work": explaining young women's contraceptive implant removal. Contraception. 2013;88(5):636–40. This qualitative study is the first to examine women's experiences with removal of the contraceptive implant. It explores women's decision making about implant removal, and also demonstrates that some women seeking to discontinue the method may encounter resistance from their providers.CrossRefPubMed

Title: The Contraceptive Implant: An Updated Review of the Evidence
Authors: Jennifer Amico
Bhavik Kumar
Hilary Rosenstein
Marji Gold
Publication date: 01-03-2015
Publisher: Springer US
Published in: Current Obstetrics and Gynecology Reports / Issue 1/2015
Electronic ISSN: 2161-3303
DOI: https://doi.org/10.1007/s13669-014-0110-y

At a glance: The STEP trials

Springer Medicine

The Contraceptive Implant: An Updated Review of the Evidence

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2015

Post-Pregnancy Intrauterine Devices: Strategies for Provision of Services

mTOR Signaling in Endometrial Cancer: From a Molecular and Therapeutic Point of View

Current Status of Multipurpose Prevention Technology (MPT) Development

Update on Hormonal Contraception and Obesity

Contraception for Adolescents: Focusing on Long-Acting Reversible Contraceptives (LARC) to Improve Reproductive Health Outcomes

Ovarian Cancer and Drug Resistance