Bleeding profile in users of an etonogestrel sub-dermal implant. Effects of anthropometric variables.
ESC Congress Library. De Rosa N. May 28, 2014; 50584; A-169
Dr. Nicoletta De Rosa
Dr. Nicoletta De Rosa
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To evaluate the menstrual bleeding profile of an healthy Italian population using etonogestrel (ENG) releasing implant for contraception and to identify possible correlation with different anthropometric and biological variables.


A prospective observational study was conducted in the Contraception Clinics of our Departments. Ninety-two healthy, sexually active women, with childbearing potential, desiring long-term contraception were enrolled in the trial. Weight, height and BMI were measured for each patient at baseline and 3, 6, 9 and 12 months after implant positioning. Patients were asked to record every day the occurrence of any bleeding or spotting. The bleeding/spotting pattern (Amenorrhea/Infrequent/Normal/Frequent or Prolonged bleeding) was evaluated over consecutive 90-day intervals (“Reference Period” – RP. Patients who showed a favourable bleeding profile (amenorrhea, infrequent or normal bleeding) for 50% or more of the RPs were assigned to group A, while patients who showed a favourable bleeding profile for less than 50% of the RPs were assigned to group B. χ2 and Student t-test were used to compare categorical and continuous data between groups, respectively.


Eighty-six women completed at least 6 months of follow up and were included in the analysis. In the first RP the most frequent bleeding profile was amenorrhea, during the other RPs there was an increase in the percentage of patients with bleeding/spotting. Sixty-eight women (79.1%) were assigned to group A and 18 women (20.9%) to group B. Group B had lower baseline BMI than group A (24.84 ± 4.95 vs 20.75 ± 4.41; p< .005). In group B, a higher percentage of women had 2 or more previous pregnancies in comparison with group (94% vs 82%; p<.005).


The ENG sub-dermal implant is an effective and well-tolerated contraceptive method, with a high percentage of women experiencing a favourable bleeding profile. The lower basal BMI in Group B in comparison to Group A may account for the higher percentage of irregular bleeding through an hormonal milieu characterized by lower endogenous estrogen levels leading to a reduced endometrial stability.

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