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含依托孕烯的避孕植入剂(依伴侬)的可接受性

[Acceptability of the etonogestrel-containing contraceptive implant (Implanon)].

作者信息

Sergent F, Clamageran C, Bastard A-M, Verspyck E, Marpeau L

机构信息

Clinique Gynécologique et Obstétricale, Pavillon Mère-Enfant, Hôpital Charles Nicolle, 1, rue de Germont, 76031 Rouen Cedex.

出版信息

J Gynecol Obstet Biol Reprod (Paris). 2004 Sep;33(5):407-15. doi: 10.1016/s0368-2315(04)96548-9.

Abstract

OBJECTIVES

To estimate the exact satisfaction of women toward Implanon, the sole contraceptive implant available in France. To clarify the indications of this type of contraception.

MATERIAL AND METHOD

Among a population of 182 women with Implanon" inserted in a same family planning service between May 22, 2001 and February 14, 2003, 108 women agreed to answer a questionnaire of satisfaction. Implants were inserted in one third of cases after childbirth, in another third after abortion. The average duration of use of the implant was of 16 months (2 in 24 months). Twenty-nine removals among the 108 insertions (27%) were recorded.

RESULTS

Possibility of a long-term and easy -to-use contraception was the most common reason for choosing Implanon (74% of the women). Eighty-one percent of the women were globally satisfied with Implanon but one out of two women had side-effects. Only 62% of the women were ready to use it again. Adverse events were first, menstrual disturbance in 83% of the women, mainly amenorrhea (26%) and bleeding irregularity (40%). Bleeding irregularity was one of the main motives for discontinuing the implant in 41% of cases. Except weight gain present for 37% of patients, the other side-effects, even though they were frequent, were less often the reason for removal. Headache, acne, breast pain, mood and decreased libido were the main reasons for removal.

CONCLUSION

Implanon has certainly a place among current contraceptive methods. Because of the frequency raised by adverse events and by their lower tolerance in Europe, this place has to remain limited to the incapacity of classic methods. Preinsertion counseling announcing Implanon's benefit and risk effects is necessary to minimize the early discontinuation rates.

摘要

目的

评估法国唯一可用的避孕植入剂依伴侬(Implanon)在女性中的实际满意度。阐明这类避孕方式的适用情况。

材料与方法

在2001年5月22日至2003年2月14日期间,同一家计划生育服务机构为182名女性植入了依伴侬,其中108名女性同意回答一份满意度调查问卷。三分之一的植入是在产后进行,另外三分之一是在流产后进行。植入剂的平均使用时长为16个月(24个月内的2个月)。在108次植入中,记录到29次取出(27%)。

结果

可长期且易于使用的避孕方式是选择依伴侬最常见的原因(74%的女性)。81%的女性总体上对依伴侬感到满意,但有一半的女性出现了副作用。只有62%的女性愿意再次使用。不良事件首先是83%的女性出现月经紊乱,主要是闭经(26%)和出血不规律(40%)。出血不规律是41%的病例中停止使用植入剂的主要原因之一。除了37%的患者出现体重增加外,其他副作用尽管常见,但较少成为取出的原因。头痛、痤疮、乳房疼痛、情绪问题和性欲下降是取出的主要原因。

结论

依伴侬在当前避孕方法中确实占有一席之地。由于不良事件发生率较高以及在欧洲较低的耐受性,这一席之地必须限于传统方法无能为力的情况。植入前咨询告知依伴侬的益处和风险效应对于尽量降低早期停用率是必要的。

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