Invasive contraceptive method

Implanon

Objectives By the end of this lecture the student will be able

Define the implanon

Explain the action of it

Explain complication

Discuss the indication &contraindication

Definition The birth control implant is a tiny,

thin rod like the size of a matchstick.

It's also called Nexplanon and

there's a slightly older version called

Implanon. It is inserts in the skin of

the upper arm. It releases the

hormone progestin to stop getting

pregnant

Old implanon Norplant (levonorgestrel) Implants is a

hormonal contraceptive used to prevent

pregnancy up to 3years

The Norplant System consists of six

Silastic capsules, each containing

( 36 mg) of the progestin, levonorgestrel.

The total administered (implanted) dose

is( 216) mg.

available in a sterile disposable

( 4 cm long by 2 mm wide)

containing 68 mg of etonogestrel. It

is more than 99% effective at

preventing pregnancy and can last

for up to three years, This implant

has not been studied in female

patients under age 18.

action prevent pregnancy in two ways:

Progestin thickens the mucus on cervix, which

stops sperm from swimming through to the egg.

Progestin can also stop eggs from leaving the

ovaries (called ovulation), so there’s no egg to

fertilize.

Drugs interaction

interact with phenytoin, carbamazepine, rifampin, and

hepatic enzyme inducers this medication are inhibit the

action of the hormone .

Side effects

Common side effects of Nexplanon include:

missed periods (amenorrhea)

bleeding and spotting between periods,

heavier bleeding during the first few weeks after device

insertion,

Abdominal pain ,Headache and ovarian cysts,

Side effects Nervousness.

Dizziness.

Nausea.

vomiting

breast tenderness or pain

weight gain(Bloating.)

changes in hair growth,

Depression & acne

changes in mood

loss of interest in sex

itching or skin rash

CONTRAINDICATIONS Known or suspected pregnancy

Current or past history of thrombosis or thromboembolic

disorders Liver tumors, benign or malignant, or active liver

disease

Undiagnosed abnormal genital bleeding

known or suspected breast cancer.

Allergic reaction to any of the components of IMPLANON

WARNINGS AND PRECAUTIONS

insertion and removal complications: Pain,

paresthesias(,abnormal dermal sensation with out physical

cause )

bleeding, hematoma, scarring or infection may occur.

Menstrual bleeding pattern: Counsel women regarding

changes in bleeding frequency, intensity, or duration.

ADMINISTRATIONis inserted subdermally in the upper

arm just under the skin. To reduce

the risk of neural or vascular injury,

the implant should be inserted at

the inner side of the non-dominant

upper arm about 8-10 cm (3-4

inches)..

Time of insertion

should be inserted between Day 1 (first day of menstrual bleeding)

and Day 5 of the menstrual cycle, if insert in this time she is use not

need anther contraceptive

If timing of insertion after mens , the woman should be advised to

use a barrier method until 7 days after insertion.

Site of insertion

First Trimester Following abortion or miscarriage :

IMPLANON should be inserted within 5 days

Second Trimester: Insert IMPLANON between 21 to

28 days

Benefits

reliable long term contraception

Improvement in menorrhagia and dysmenorrheal.

Easy to insert and remove

Removal

must be removed by the end of the third year and may be replaced by a

new implant at the time of removal, if continued contraceptive protection

is desired

References 1- Callahan, Tamara; Caughey, Aaron B. (2013). Blueprints Obstetrics and

Gynecology. Lippincott Williams & Wilkins. p. 320. ISBN 9781451117028.

“2- ParaGard (copper IUD)". Drugs.com. 10/1/19. Retrieved 8/1/19. Check date values in: |access-date=, |date= (help)

3- "IUD (intrauterine device)". Contraception guide. NHS Choices. Retrieved 2 March 2014. the intrauterine device, or IUD (sometimes called a coil