Can initial vaginal bleeding patterns in etonogestrel implant users predict subsequent bleeding in the first 2 years of use?
| Autor: | Andrew M. Kaunitz, Arvind Shah, Diana Mansour, Ian S. Fraser, Annpey Pong, Jianxin Lin, Alison Edelman, Hans Rekers, Mitchell D. Creinin, Tjeerd Korver, Carolina Sales Vieira, Michelle C. Fox |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty Time Factors Clinical Sciences Paediatrics and Reproductive Medicine Young Adult 03 medical and health sciences 0302 clinical medicine Contraceptive Agents Etonogestrel implant Clinical Research Contraceptive Agents Female medicine Humans Vaginal bleeding 030212 general & internal medicine Chile Obstetrics & Reproductive Medicine Amenorrhea Etonogestrel Drug Implants Desogestrel 030219 obstetrics & reproductive medicine business.industry Bleeding Continuation Implant Obstetrics and Gynecology Reference Period United States PROGESTERONA Menstruation Discontinuation Surgery Europe Reproductive Medicine Public Health and Health Services Female medicine.symptom Contraceptive implant business medicine.drug |
| Zdroj: | Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual) Universidade de São Paulo (USP) instacron:USP Contraception, vol 100, iss 4 |
| ISSN: | 0010-7824 |
| Popis: | Objectives To evaluate if a simple method for characterizing vaginal bleeding patterns in etonogestrel contraceptive implant users can predict subsequent patterns and bleeding-related discontinuation over the first 2 years of use. Study Design We reanalyzed phase 3 study bleeding data for non-breastfeeding participants from the United States, Europe, Russia and Chile during the first 2 years of implant use to characterize and correlate bleeding patterns. We used 90-day reference periods with period 1.1 starting at Day 29 and ending at Day 118. We dichotomized bleeding patterns as “favorable” (amenorrhea, infrequent bleeding and normal frequency bleeding without prolonged bleeding) or “unfavorable’ (prolonged and/or frequent bleeding) and tracked user groups based on these bleeding patterns in reference period 1.1 through Year 1 and from Year 1 through Year 2, respectively. Results We evaluated data from 537 and 428 women with up to 1 and 2 years use, respectively. Of the 325 (60.5%) women with favorable bleeding in reference period 1.1, 275 (84.6%) reported favorable bleeding also in reference period 2, 197 (60.6%) reported favorable bleeding throughout Year 1, and favorable bleeding in 75–85% of reference periods in Year 2. Among 212 (39.5%) women with unfavorable bleeding in reference period 1.1, 118 (55.7%) continued with unfavorable bleeding in reference period 2, while about 40%–50% reported favorable patterns in RP 2, 3 and/or 4. Initial favorable bleeding resulted in lower discontinuation rates than initial unfavorable bleeding in years 1 (3.7% vs 12.7%, p≪.0001) and 2 (2.5% vs 16.5%, p≪.0001). Conclusion Implant users with favorable bleeding in the first reference period are likely to continue with favorable bleeding over the next 2 years. Initial bleeding patterns predict overall continuation rates in years 1 and 2. Implications Statement When evaluating vaginal bleeding in any 90-day reference period over 2 years of etonogestrel implant use, approximately 80% of women with favorable and 40% with unfavorable bleeding patterns will have favorable bleeding in the next reference periods. These findings can facilitate counseling regarding bleeding for women using the etonogestrel implant. |
| Databáze: | OpenAIRE |
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