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Menstrual management using the etonogestrel implant in individuals with intellectual disabilities in Joinville, Brazil.
Braga, Giordana Campo; Zarabia, Carla Josene; da Trindade, Adriana Kelly Soares de S; Vieira, Carolina Sales.
Affiliation
  • Braga GC; Department of Obstetrics and Gynecology, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
  • Zarabia CJ; Department of Social Medicine, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
  • da Trindade AKSS; Núcleo de Assistência Integral ao Paciente Especial, Joinvile, SC, Brazil.
  • Vieira CS; Núcleo de Assistência Integral ao Paciente Especial, Joinvile, SC, Brazil.
Article in En | MEDLINE | ID: mdl-39350685
ABSTRACT

OBJECTIVE:

This study aimed to describe the use of etonogestrel (ENG) implants for menstrual management (i.e., management of bleeding and symptoms associated with menstruation) in individuals with intellectual disabilities.

METHODS:

This study retrospectively analyzed a cohort of individuals with intellectual disabilities who began using ENG implants between 2003 and 2018, in Joinville, Brazil. We collected sociodemographic, clinical, and reproductive data from the medical records, along with information related to ENG implant use.

RESULTS:

In total, 369 implants were placed in 130 individuals with intellectual disabilities. The median age at the first implant was 20 (interquartile range [IQR], 17-26) years, and 43.8% of the patients were adolescents. By December 2018, 90 patients had received two or more subsequent implants. The median duration of current ENG implant use was 19 (IQR, 12.8-22) months. More than 40% of the patients had comorbidities, with epilepsy being the most common. During the use of the current implant, 80% of the patients had a favorable bleeding profile (no bleeding or ≤1 bleeding episode per month), and 53.8% (70/130) had no bleeding within 3 months before their last medical visit. Among patients experiencing dysmenorrhea and premenstrual syndrome (PMS), 79% (64/81) and 82% (54/66) reported complete improvement, respectively. The premature implant removal rate was 8.9% (33/369). Unfavorable bleeding was the main reason for premature implant removal (20 out 33 removals).

CONCLUSIONS:

ENG implants might be a suitable option for individuals with intellectual disabilities who require management of menstrual bleeding and symptoms associated with menstruation. Most patients had a favorable bleeding profile and experienced significant improvements in dysmenorrhea and PMS, contributing to the high continuation rates of ENG implants.
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Country/Region as subject: America do sul / Brasil Language: En Journal: Int J Gynaecol Obstet Year: 2024 Document type: Article Affiliation country: Brazil Country of publication: United States

Full text: 1 Collection: 01-internacional Database: MEDLINE Country/Region as subject: America do sul / Brasil Language: En Journal: Int J Gynaecol Obstet Year: 2024 Document type: Article Affiliation country: Brazil Country of publication: United States