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Journal of Primary Health Care Journal of Primary Health Care Society
Journal of The Royal New Zealand College of General Practitioners
RESEARCH ARTICLE (Open Access)

New Zealand women’s experience during their first year of Jadelle® contraceptive implant

Christine Roke 1 4 , Helen Roberts 2 , Anna Whitehead 3
+ Author Affiliations
- Author Affiliations

1 National Medical Advisor, Family Planning, Auckland, New Zealand

2 Associate Professor, Women’s Health, Faculty of Medical and Health Sciences, University of Auckland, New Zealand

3 Locality Medical Advisor, Family Planning, Hamilton, New Zealand

4 Correspondence to: Dr Christine Roke, National Medical Advisor, Family Planning, Private Bag 99929, Newmarket, Auckland 1149, New Zealand. Email: christine.roke@familyplanning.org.nz

Journal of Primary Health Care 8(1) 13-19 https://doi.org/10.1071/HC15040
Published: 31 March 2016

Journal Compilation © Royal New Zealand College of General Practitioners 2016.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Abstract

INTRODUCTION: Subsidisation of the levonorgestrel-releasing Jadelle® contraceptive implant in 2010 resulted in a rapid uptake. Clinicians had little prior experience of client satisfaction, side effect profile, and removal rate of this contraceptive method.

AIM: To obtain information on satisfaction, bleeding patterns, continuation rates and reasons for removal for New Zealand women during their first year of use of a subsidised contraceptive implant, Jadelle®.

METHODS: Women having a Jadelle® implant inserted in New Zealand Family Planning clinics were recruited to be followed up by phone, text or email at 1, 3, 6, 9 and 12 months. They were asked about their bleeding pattern, satisfaction and their views on benefits of, or problems with, implant use.

RESULTS: 252 women were recruited. The three common bleeding patterns in the cohort were regular periods, amenorrhoea and irregular bleeding. Eighteen percent had their implant removed within the first year with more than half of those being unhappy with their bleeding pattern. This was usually prolonged bleeding. Otherwise satisfaction rates were high throughout the year.

DISCUSSION: The majority of New Zealand women using Jadelle® were satisfied with this method of contraception during their first year of use. Implant removals were most likely to be related to prolonged bleeding. However the commonest bleeding pattern was regular periods.

KEYWORDS: Contraceptive implant; progestin; bleeding; satisfaction; continuation rate; reducing reproductive health inequalities


References

[1]  http://www.medsafe.govt.nz/profs/datasheet/j/Jadelleimplant.pdf. Accessed 12.12.15.

[2]  Winner B, Peipert JF, Zhao Q, et al. Effectiveness of Long-Acting Reversible Contraception. N Engl J Med 2012; 366 1998–2007.
Effectiveness of Long-Acting Reversible Contraception.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38XotVynsL4%3D&md5=7f8bbc623501f595987f16dd446ad1aeCAS | 22621627PubMed |

[3]  Meirik O, Fraser IS. d’Argangues C for the WHO Consultation on Implantable contraceptives for women. Implantable contraceptives for women. Hum Reprod Update 2003; 9 49–59.
d’Argangues C for the WHO Consultation on Implantable contraceptives for women. Implantable contraceptives for women.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD3sXjtVelt7c%3D&md5=0738db131329f39073c95dfc5790361fCAS | 12638781PubMed |

[4]  Hickey M, d’Arcangues C. Vaginal bleeding disturbances and implantable contraceptives. Contraception 2002; 65 75–84.
Vaginal bleeding disturbances and implantable contraceptives.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD38XhtlGgsbo%3D&md5=ecec6d03a91101f9bed3d7db8aea0a00CAS | 11861057PubMed |

[5]  Zheng SR, Zheng HM, Qian SZ, et al. A randomized multicenter study comparing the efficacy and bleeding pattern of a single-rod (Implanon) and a six-capsule (Norplant) hormonal contraceptive implant. Contraception 1999; 60 1–8.
A randomized multicenter study comparing the efficacy and bleeding pattern of a single-rod (Implanon) and a six-capsule (Norplant) hormonal contraceptive implant.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DyaK1MXntVCgsLk%3D&md5=4c08a85fe26b972f8c7e6c5ad30aa79eCAS | 10549446PubMed |

[6]  Fraser IS, Titinen A, Affandi B, et al. Norplant® Consensus and background review. Contraception 1998; 57 1–9.
Norplant® Consensus and background review.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1c3hsVylsQ%3D%3D&md5=f0403e10678d25bb7ebdf2f772005935CAS | 9554244PubMed |

[7]  Sivin I, Campodonico I, Kiriwat O, et al. The performance of levonorgestrel rod and Norplant contraceptive implants: a 5-year randomized study. Hum Reprod 1998; 13 3371–8.
The performance of levonorgestrel rod and Norplant contraceptive implants: a 5-year randomized study.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DyaK1MXltFOltg%3D%3D&md5=658931bcc95b5394d823809c758b6b43CAS | 9886517PubMed |

[8]  Sivin I, Mishell DR, Darney P, et al. Levonorgestrel capsule implant in the United States: a 5-year study. Obstet Gynecol 1998; 92 337–44.
Levonorgestrel capsule implant in the United States: a 5-year study.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DyaK1cXlvVylsbg%3D&md5=c31278e9c2ea24f1bd80c7dc3e6cc43cCAS | 9721766PubMed |

[9]  http://www.fsrh.org/pdfs/CEUGuidanceProblematicBleedingHormonalContraception.pdf 2012. Accessed 13.12.15.

[10]  Hoggart L, Newton VL, Dickson J. ‘I think it depends on the body, with mine it didn’t work’: explaining young women’s decisions to request subdermal contraceptive implant removal. Contraception 2013; 88 636–40.
‘I think it depends on the body, with mine it didn’t work’: explaining young women’s decisions to request subdermal contraceptive implant removal.Crossref | GoogleScholarGoogle Scholar | 23829976PubMed |

[11]  Dickson J, Hoggart L, Newton VL. Unanticipated bleeding with the etonogestrel implant: advice and therapeutic interventions. J Fam Plann Reprod Health Care 2014; 40 158–60.
Unanticipated bleeding with the etonogestrel implant: advice and therapeutic interventions.Crossref | GoogleScholarGoogle Scholar | 24939479PubMed |

[12]  Mansour D, Bahamondes L, Critchley H, et al. The management of unacceptable bleeding patterns in etonogestrel-releasing contraceptive implant users. Contraception 2011; 83 202–10.
The management of unacceptable bleeding patterns in etonogestrel-releasing contraceptive implant users.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3MXhvVyrsbk%3D&md5=1033d1838676fb6ee439543a07351e7aCAS | 21310280PubMed |

[13]  Progestogen-only implants 2014. http://www.fsrh.org/pdfs/CEUGuidanceProgestogenOnlyImplants.pdf. Accessed 13.12.15.

[14]  O’Neil-Callahan M, Peipert JF, Zhao Q, et al. Twenty-Four–Month Continuation of Reversible Contraception. Obstet Gynecol 2013; 122 1083–91.
Twenty-Four–Month Continuation of Reversible Contraception.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3sXhs1Oku7bI&md5=edd418cb7064121bbd35f9d3bd5f48c4CAS | 24104781PubMed |

[15]  Sivin I. Risks and benefits, advantages and disadvantages of levonorgestrel releasing contraceptive implants. Drug Saf 2003; 26 303–35.
Risks and benefits, advantages and disadvantages of levonorgestrel releasing contraceptive implants.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD3sXjsFyiurs%3D&md5=de8dae73b6291698071c7bfa4c3c4c7dCAS | 12650633PubMed |

[16]  http://www.choiceproject.wustl.edu/ accessed 1 March 2015.

[17]  http://www.justice.govt.nz/tribunals/abortion-supervisory-committee/annual-reports/asc-annual-report-2014. Accessed 13.12.15.

[18]  Vekemans M, Delvigan A, Paesmans M. Continuation rates with levonorgestrel-releasing contraceptive implant (Norplant). A retrospective study in Belgium. Contraception 1997; 56 291–9.
Continuation rates with levonorgestrel-releasing contraceptive implant (Norplant). A retrospective study in Belgium.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DyaK1cXkvFOrtw%3D%3D&md5=04bfae7422be6340ba5b486cced1d9d8CAS | 9437557PubMed |