For women who find daily birth control pills inconvenient,
implantable contraceptives may be a new solution to their
problems.
A contraceptive rod called Implanon was approved by the Food and
Drug Administration last month, making the implant available to
American women in the near future.
The 1.5-inch rod, inserted into the upper arm, works by
releasing a type of progesterone hormone called etonogestrel over a
period of three years, said Anita Nelson, a professor and doctor at
Harbor UCLA Medical Center.
The rod can only be administered by trained professionals and
the cost has not yet been determined.
“The goal is to suppress ovulation and thicken cervical
mucus so the sperm can’t reach the egg,” Nelson said.
“The prevention of fertilization should make people very
comfortable.”
Compared to other contraceptive methods such as the birth
control pill, which has to be carefully taken each day at the same
time to achieve a 92 percent success rate, Implanon is more
effective ““ it has a 99 percent protection rate, said Ram
Parvataneni, an assistant professor at the UCLA Department of
Obstetrics and Gynecology.
“In the U.S. study from which FDA approval was obtained,
no pregnancies were reported,” Parvataneni said. “It is
very effective, even more so than sterilization.”
The reason for such high success is that it does not require
daily attention or maintenance, but acts on its own.
“Implanon is so important because once it is inserted, it
is independent of user compliance,” he said.
Though Implanon has been shown to be effective in birth control,
it, like birth control pills, does nothing to prevent sexually
transmitted diseases, Nelson said.
“It’s difficult to make something that will address
the problems of both contraception and STDs without sacrificing the
quality of either one,” said Nelson. “I think of it as
a package deal. Condoms and contraceptive devices should be used
together.”
Implanon does have side effects, the main one being irregular
vaginal bleeding, Nelson said.
“Some people will have excessive bleeding and others
won’t have periods at all,” she said. “As
off-putting as that sounds, it’s amazing how many women kept
it in because their trust in it outweighed the
inconvenience.”
Other, less common side effects include headaches and
depression.
“Most women probably will not react to etonogestrel, but
there will be a proportion of women who are at risk for emotional
side effects,” said Andrea Rapkin, a professor at the UCLA
Department of Obstetrics and Gynecology.
Despite these drawbacks, experts say Implanon is safe because it
releases only progesterone and not estrogen. Estrogen, contained in
birth control pills, causes most of the pill’s side effects,
such as problems in blood clotting, said Angela Chen, a family
planning specialist at the UCLA Department of Obstetrics and
Gynecology.
Organon, the company producing Implanon, has eliminated problems
associated with other contraceptive methods as well, including a
previous implant called Norplant. Norplant consisted of six rods
but was discontinued in the United States in 2000 due to
overselling without training providers fast enough, as well as
injuries during removal.
The presence of only one rod will allow for 1-minute insertions
and 2-minute removals, while widespread efforts to train providers
will increase competence, Nelson said.
“I can’t prescribe Implanon unless I’m trained
for it first,” she said. “Training is not just about
how to put the rod in. It’s also about the counseling that
must be given to the patients.”
Organon will start training providers at the end of the month,
and Implanon will not be widely available until the middle of next
year, said Parvataneni.
The price for Implanon has not yet been determined.
“They’re bringing Implanon into the community with a
slow domino effect,” Nelson said. “Patients will
absolutely love it, and there’s a huge potential for
popularity among college students because of their chaotic
lifestyle.”