Abstract
Study Objective
Long-acting reversible contraception, including the contraceptive implant, is recommended
for teens and young women. However, some young women discontinue the implant early,
and we seek to better understand their experiences.
Design, Setting, and Participants
We conducted interviews with 16 young women ages 14 to 24 who presented for removal
of the contraceptive implant within 6 months after placement at outpatient adolescent,
family medicine, and obstetrics and gynecology clinics. We coded and analyzed transcripts
to identify themes and develop a thematic framework.
Interventions and Main Outcome Measures
We explored decision-making regarding placement and removal of the implant, differences
between anticipated and experienced side effects, and recommendations for counseling.
Results
The participants reported experiencing significant side effects that led to removal,
most often frequent or heavy bleeding or mood changes. These healthy young women were
unprepared for these symptoms, despite remembering being told about possible side
effects. Participants wanted more concrete examples of possible side effects, and
personal stories of side effects experienced by others, rather than general terms
such as irregular bleeding or mood changes. Few discussed problems with their providers;
instead, they relied on the Internet or friends to help decide when to remove the
implant. Nearly half of the participants did not start new contraception after removal,
although they voiced a continued desire to avoid pregnancy.
Conclusion
We identified a need for more descriptive counseling about side effects experienced
by individuals, and guidance on what to do about problems encountered after placement.
Key Words
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Article info
Publication history
Published online: January 06, 2017
Footnotes
B.L. is an unpaid trainer for Nexplanon. The other authors indicate no conflicts of interest.
Identification
Copyright
© 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.
