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Considerations in Adolescent Use of the Etonogestrel Subdermal Implant: A Cohort Study

Objectives: To describe bleeding patterns and other side effects in adolescent implant users and characterize their impact on early discontinuation of the implant. Study Design: This is a retrospective cohort study of female patients under 18 years who had an implant placed from 2013 to 2018. Data w...

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Autores principales: Fei, Y. Frances, Smith, Yolanda R., Dendrinos, Melina L., Rosen, Monica W., Quint, Elisabeth H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9580660/
https://www.ncbi.nlm.nih.gov/pubmed/36304012
http://dx.doi.org/10.3389/frph.2021.780902
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author Fei, Y. Frances
Smith, Yolanda R.
Dendrinos, Melina L.
Rosen, Monica W.
Quint, Elisabeth H.
author_facet Fei, Y. Frances
Smith, Yolanda R.
Dendrinos, Melina L.
Rosen, Monica W.
Quint, Elisabeth H.
author_sort Fei, Y. Frances
collection PubMed
description Objectives: To describe bleeding patterns and other side effects in adolescent implant users and characterize their impact on early discontinuation of the implant. Study Design: This is a retrospective cohort study of female patients under 18 years who had an implant placed from 2013 to 2018. Data were collected on demographics, medical history, and side effects. Results: Of 212 adolescents, the average age at insertion was 16 years and 84% desired placement for contraception. Common side effects included AUB (80%), mood changes (10%), and perceived weight gain (9%). Most (76%) used the implant for at least 12 months. Average time to removal was 22.1 months (SD 13.0 months) and this did not depend on presence of side effects. Twenty-seven percent of teens were able to achieve amenorrhea. Adolescents with frequent or prolonged bleeding were more likely to have implant removal prior to 12 months than those with other bleeding patterns (p = 0.003). Early removal was also more common in girls reporting weight or mood issues than those who did not (p < 0.001 and p = 0.045, respectively). BMI increased in 64% of adolescents. Average percentage change in BMI was 3.2% (0.87 kg/m(2)). There was no difference in baseline use of any mood-modulating medications in patients who did and did not complain of mood side effects following implant placement (p = 0.801). Conclusion: Characterization of bleeding patterns following implant placement in adolescents have not previously been reported. Prolonged or heavy bleeding, mood issues, and perceived weight gain were associated with earlier removal of the implant. A relatively small number had early removal of the implant due to weight or mood complaints. Therefore, a history of obesity, depression, or other mood disorders should not be a deterrent to implant placement.
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spelling pubmed-95806602022-10-26 Considerations in Adolescent Use of the Etonogestrel Subdermal Implant: A Cohort Study Fei, Y. Frances Smith, Yolanda R. Dendrinos, Melina L. Rosen, Monica W. Quint, Elisabeth H. Front Reprod Health Reproductive Health Objectives: To describe bleeding patterns and other side effects in adolescent implant users and characterize their impact on early discontinuation of the implant. Study Design: This is a retrospective cohort study of female patients under 18 years who had an implant placed from 2013 to 2018. Data were collected on demographics, medical history, and side effects. Results: Of 212 adolescents, the average age at insertion was 16 years and 84% desired placement for contraception. Common side effects included AUB (80%), mood changes (10%), and perceived weight gain (9%). Most (76%) used the implant for at least 12 months. Average time to removal was 22.1 months (SD 13.0 months) and this did not depend on presence of side effects. Twenty-seven percent of teens were able to achieve amenorrhea. Adolescents with frequent or prolonged bleeding were more likely to have implant removal prior to 12 months than those with other bleeding patterns (p = 0.003). Early removal was also more common in girls reporting weight or mood issues than those who did not (p < 0.001 and p = 0.045, respectively). BMI increased in 64% of adolescents. Average percentage change in BMI was 3.2% (0.87 kg/m(2)). There was no difference in baseline use of any mood-modulating medications in patients who did and did not complain of mood side effects following implant placement (p = 0.801). Conclusion: Characterization of bleeding patterns following implant placement in adolescents have not previously been reported. Prolonged or heavy bleeding, mood issues, and perceived weight gain were associated with earlier removal of the implant. A relatively small number had early removal of the implant due to weight or mood complaints. Therefore, a history of obesity, depression, or other mood disorders should not be a deterrent to implant placement. Frontiers Media S.A. 2021-12-23 /pmc/articles/PMC9580660/ /pubmed/36304012 http://dx.doi.org/10.3389/frph.2021.780902 Text en Copyright © 2021 Fei, Smith, Dendrinos, Rosen and Quint. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Reproductive Health
Fei, Y. Frances
Smith, Yolanda R.
Dendrinos, Melina L.
Rosen, Monica W.
Quint, Elisabeth H.
Considerations in Adolescent Use of the Etonogestrel Subdermal Implant: A Cohort Study
title Considerations in Adolescent Use of the Etonogestrel Subdermal Implant: A Cohort Study
title_full Considerations in Adolescent Use of the Etonogestrel Subdermal Implant: A Cohort Study
title_fullStr Considerations in Adolescent Use of the Etonogestrel Subdermal Implant: A Cohort Study
title_full_unstemmed Considerations in Adolescent Use of the Etonogestrel Subdermal Implant: A Cohort Study
title_short Considerations in Adolescent Use of the Etonogestrel Subdermal Implant: A Cohort Study
title_sort considerations in adolescent use of the etonogestrel subdermal implant: a cohort study
topic Reproductive Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9580660/
https://www.ncbi.nlm.nih.gov/pubmed/36304012
http://dx.doi.org/10.3389/frph.2021.780902
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