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Contraceptive Implants Session I: Characteristics of Implants

Contraceptive Implants Session I: Characteristics of Implants. Adapted by Dr Rodica Comendant, based on Training Resource Package for Family Planning: https://www.fptraining.org/. What Are Implants?. Progestin-filled rods (each about the size of a match stick) that are inserted under the skin

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Contraceptive Implants Session I: Characteristics of Implants

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  1. Contraceptive ImplantsSession I: Characteristics of Implants Adapted by Dr Rodica Comendant, based on Training Resource Package for Family Planning: https://www.fptraining.org/

  2. What Are Implants? Progestin-filled rods (each about the size of a match stick) that are inserted under the skin • Jadelle: 2-rod system, effective for 5 years • Sino-implant (II): 2-rod system, effective for 4 years (possibly 5) • Implanon: 1-rod system, effective for 3 years • Norplant: 6-capsule system, effective for 5 years (possibly 7); no longer manufactured but some women are still using it

  3. Key Points for Providers and Clients What it is: – Small tubes placed under the skin of inner, upper arm. – Hormones from the tubes blocks sperm from reaching egg and prevents release of egg. How to use: – Specially trained provider inserts and removes implants. – Nothing to remember to do after insertion. What to expect: – Changes in monthly bleeding including irregular bleeding, spotting, heavier bleeding or no monthly bleeding, are common and safe. Important to remember: – Use another method if waiting for appointment. – Use condoms if you need protection from STIs or HIV/AIDS.

  4. Key Points for Clients • Safe to use • One of the most effective methods • Lasts for 3 to 5 years • Can be removed any time if you want to get pregnant

  5. Effectiveness of Implants More effective Implants Less effective In this progression of effectiveness, where would you place implants? More effective Less effective

  6. Relative Effectiveness of FP Methods

  7. Implants: Mechanism of Action Implants work in two ways Suppresses hormones responsible for ovulation Thickens cervical mucus to block sperm Implants have no effect on an existing pregnancy.

  8. Implants: Characteristics • Have side effects • Require minor surgery to insert and remove • Cannot be initiated and discontinued without provider’s help • Provide no protection from STIs/HIV • Very safe and 99.95% effective • Easy to use • Fertility returns without delay when removed • Can be used by breastfeeding women • Offer health benefits Source: Hatcher, 2007; WHO, 2010; CCP and WHO, 2011.

  9. Implants: Health Benefits • Reduced risk of symptomatic pelvic inflammatory disease (PID) • Reduced risk of iron-deficiency anemia • Reduced risk of ectopic pregnancy • 6 per 100,000 in implant users • 650 per 100,000 in women using no contraception Source: CCP and WHO, 2011; Task Force for Epidemiological Research on Reproductive Health, 1998.

  10. Some users report changes in bleeding patterns: Possible Side Effects of Implants (part 1) First several months: • Lighter bleeding and fewer days of bleeding • Irregular bleeding • Infrequent bleeding • No monthly bleeding After about one year: • Lighter bleeding and fewer days of bleeding • Irregular bleeding • Infrequent bleeding How would you feel about these side-effects? *Implanon users are more likely to have no monthly bleeding than irregular bleeding.

  11. Possible Side Effects of Implants (part 2) • Headaches • Lower abdominal pain • Acne (can improve or worsen) • Weight change • Breast tenderness • Dizziness • Mood changes • Nausea, nervousness

  12. Jadelle: Continuation Rates andReasons for Discontinuation Cumulative Discontinuation Rate per 100 Women 30.5 25.9 24.3 23.4 0.8 Cumulative Continuation 82.7 66.2 49.5 36.6 27.4 Rate per 100 Women Source: Sivin et al., 1998.

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