“I think it depends on the body, with mine it didn't work”: explaining young women's contraceptive implant removal

• Published in: Contraception (Stoneham) Vol. 88; no. 5; pp. 636 - 640
• Main Authors: Hoggart, Lesley, Louise Newton, Victoria, Dickson, Jane
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.11.2013; Elsevier
• Subjects: Adolescent; Adolescent Behavior; Adult; Attitude to Health; Biological and medical sciences; Birth control; Contraception Behavior; Contraceptive Agents, Female - adverse effects; Contraceptive discontinuation; Decision Making; Device Removal; Drug Implants; Family Planning Services; Female; Genital system. Reproduction; Gynecology. Andrology. Obstetrics; Headache - chemically induced; Headache - prevention & control; Health Services Accessibility; Hormonal contraception; Humans; Implanon; LARC; London; Medical sciences; Mood Disorders - chemically induced; Mood Disorders - prevention & control; Nexplanon; Obstetrics and Gynecology; Patient Education as Topic; Patient Satisfaction; Pharmacology. Drug treatments; Subdermal contraceptive implant; Time Factors; Uterine Hemorrhage - etiology; Uterine Hemorrhage - prevention & control; Weight Gain - drug effects; Young Adult; London; Nexplanon; Hormonal contraception; LARC; Contraceptive discontinuation; Implanon; Subdermal contraceptive implant; Removal; Human; Implant; Controlled release form; Toxicity; Contraception; Long term; Progestagen; Etonogestrel; Treatment withdrawal; Dosage form; Female; Subcutaneous administration; Contraceptive; Woman
• ISSN: 0010-7824; 1879-0518
• DOI: 10.1016/j.contraception.2013.05.014

Abstract Background Our study was conducted to learn more about why some young women (under 24) request “early” removal of the subdermal contraceptive implant (implant). Study Design A qualitative study in which 20 young women were interviewed in-depth, along with nine health providers of the implant. This paper concentrates on the findings from the interviews with young women. Results Overwhelmingly, the reason given for removal was intolerable side effects, the most common being bleeding irregularities. Other hormonal side effects mentioned were mood swings, headaches and weight gain; and it was often a combination of factors that brought participants to a “tipping point” at which their negative experiences outweighed the positive attributes of the implant. Many participants felt that they had not been sufficiently warned about all possible side effects, and some were frustrated by delays encountered after they requested removal. Conclusion Women need to be made aware of all possible side effects and be given more support once the implant is in place. In supporting women's contraceptive choice, clinicians need to accept that some women are unable to tolerate the implant and that encouraging retention without dealing with distressing side effects may be counterproductive.