ABSTRACT
BACKGROUND: This prospective study analyzed the metabolic effects of an etonogestrel implant used for 1 year by adolescents. STUDY DESIGN: The study population comprised 47 postpartum adolescents (mean 17.2 years old) managed at the Family Planning Sector of São Paulo Federal University. Participants received an implant containing etonogestrel (68 mg) within 6 months of delivery (on average 102 days after giving birth) and were followed for 1 year. Blood was collected at baseline and 12 months later to assess total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), hemogram, urea, creatinine, sodium, potassium, fasting glucose, serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT) and bilirubin. RESULTS: Three adolescents did not return after receiving the implant despite telephone messages and a telegram and were excluded from the clinical and final laboratory analyses. All 44 patients completed the 12 months of follow-up, resulting in a study discontinuation rate of 0%. No implants were removed. Laboratory analyses were completed in 37 adolescents. After 1 year of using the implant, there was a significant increase in mean hemoglobin, hematocrit and indirect bilirubin concentrations and of the HDL-C/TC and HDL-C/LDL-C ratios. Additionally, there was a significant decrease in mean TC level as well as LDL-C, very low-density lipoprotein cholesterol, TG, SGOT and SGPT. These results suggest that the etonogestrel implant does not interfere directly with the risk of cardiovascular diseases because it improves the lipid profile. There were no pregnancies during the study. CONCLUSION: Our results indicate that an etonogestrel implant used by adolescents for 1 year is associated with changes in the lipid profile and hepatic function without adverse clinical effects.
Subject(s)
Contraceptive Agents, Female/administration & dosage , Desogestrel/administration & dosage , Progesterone Congeners/administration & dosage , Adolescent , Adolescent Health Services , Alanine Transaminase/blood , Aspartate Aminotransferases/blood , Bilirubin/blood , Blood Glucose , Brazil , Cholesterol/blood , Cholesterol, HDL/blood , Cholesterol, LDL/blood , Drug Implants , Family Planning Services , Female , Hematocrit , Humans , Liver Function Tests , Postpartum Period , Prospective Studies , Triglycerides/bloodABSTRACT
BACKGROUND: This prospective noncomparative observational study evaluated the clinical aspects of adolescents who received an etonogestrel implant within 6 months of delivery. STUDY DESIGN: The study population comprised 44 adolescents managed at the Family Planning Sector of São Paulo Federal University. The implant was inserted, on average, 102 days after delivery and patients were followed during 1 year. At each monthly visit to the clinic, the participants were weighed, had their blood pressure measured and were asked to report on symptoms experienced during the last 30 days. RESULTS: Approximately one-third (38.6%) of the participants reported symptoms, mostly headaches. There were no complaints of dysmenorrhea, breast tenderness or lower leg edema throughout the 12 months of follow-up. Mean body weight dropped 1.2 kg on average, from 56.4 kg at implant insertion to 55.3 kg at the end of the 1-year period. Body mass index also decreased 0.5 kg/m(2) on average, although these changes did not reach statistical significance. Systolic and diastolic blood pressure remained unchanged throughout the study period. There were no pregnancies and none of the participants discontinued the method (528 women-months). CONCLUSION: These findings suggest that the etonogestrel implant is a safe and effective contraceptive method that is well accepted by adolescents after a pregnancy.
Subject(s)
Contraception/methods , Contraceptive Agents, Female/administration & dosage , Desogestrel/administration & dosage , Adolescent , Blood Pressure/drug effects , Body Weight/drug effects , Chi-Square Distribution , Drug Implants , Female , Humans , Prospective Studies , Surveys and QuestionnairesABSTRACT
BACKGROUND: The increasing rate of teenage pregnancies is a challenge to health professionals. New contraceptive methods have been developed to try to improve adherence in this group of patients. The study was conducted to evaluate the bleeding pattern, efficacy and discontinuation rate of etonogestrel implant (68 mg) inserted in postpartum adolescents. STUDY DESIGN: The study population comprised 44 postpartum adolescents managed at the Family Planning Sector of São Paulo Federal University. The implant was inserted, on average, 102 days after delivery. Patients were followed prospectively during four 90-day periods. RESULTS: All 44 patients completed the 12 months of follow-up, resulting in a study discontinuation rate of 0%. No implants were removed. There were no pregnancies during the study. After 1 year of use, frequent and prolonged bleeding were reported by less than 5% of the patients and amenorrhea occurred in 38.6% of the users. Laboratory parameters indicated a significant increase in hemoglobin and hematocrit among users. CONCLUSION: These findings suggest that the etonogestrel implant is a safe and effective contraceptive method that is well accepted by adolescents after a pregnancy.
