Izabella Jawad


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    Etonogestrel subdermal implant (Implanon) and overweight/obesity- does it work?
    Izabella Jawad, Ingrid Östlund
    Department of Obstetrics and Gynaecology, University Hospital in Örebro, Sweden
    Background: Overweight and obesity are the cumulative problems in many countries.
    Overweight and obesity have special implications on contraception. Hormonal methods
    supposed to be less effective in women with overweight/obesity. Combined oral
    contraception in women with overweight /obesity are associated with elevated risks for
    DVT. The objective of this study was to evaluate etonogestrel subdermal contraceptive
    implant’s (Implanon) tolerability, efficacy, adverse effects and user continuation rate in
    women with overweight and obesity.
    Material and methods: A prospective cohort study of 75 women with overweight (BMI 25-
    29) and obesity ( BMI >30) who got Implanon insert under period the 01/01/2001 –
    07/08/2002. Reasons for discontinuation and lifetime for Implanon were registrated.
    Results: Mean age of women was 27,5 years (15-44 years). 34 women (45%) were
    overweight and 41 women (55 %) were obese. Compliance under 3 years period in
    overweight group was 50% and in obese group 56%. Totally 40 women (53%) completed
    usage of Implanon and 23 of them (30%) changed to a new one.
    Lifetime for Implanon at 12 months was 75 %, at 24 months 53% and at 35 months 53%.
    None unintended pregnancy was noted.
    Most common reason for discontinuation was menstrual disorders – 17 women (22,5%)
    Other adverse effects (acne, headache and moodchanges), which lead to discontinuation,
    were at cumulative rate of 16%.
    Conclusion: Efficacy and tolerability in users of etonogestrel subdermal implant
    (Implanon) with overweight/obesity are high and doesn’t differ in those groups of women
    compared to women with normal BMI as well as adverse effects rate.
    Almost 60% of women could have a reliable contraceptive method under a period of two
    years and more than a half could use it under three years period.