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Research Article| Volume 35, ISSUE 3, P341-345, June 2022

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Tamoxifen for the Treatment of Etonogestrel Implant-Associated Bleeding in an Adolescent Gynecology Practice

Published:November 12, 2021DOI:https://doi.org/10.1016/j.jpag.2021.11.001
Tamoxifen for the Treatment of Etonogestrel Implant-Associated Bleeding in an Adolescent Gynecology Practice
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      ABSTRACT

      Objective

      To describe clinical outcomes in a cohort of adolescent female patients using tamoxifen for the treatment of bothersome etonogestrel (ENG) implant-associated bleeding.

      Design

      Retrospective chart review

      Setting

      A tertiary children's hospital

      Participants

      Adolescent female patients ages 12–21 seen between August 2016 and August 2019 with an ENG implant in place who received a tamoxifen prescription for the indication of implant-associated bleeding.

      Interventions

      None

      Main Outcome Measures

      Main outcome measures were implant continuation rates, average time to implant discontinuation after tamoxifen prescription, reasons for implant removal, number of doses and timing of tamoxifen use, bleeding patterns, and adverse effects.

      Results

      A total of 67 patients met the inclusion criteria. The mean age of patients was 16.7 years old. Of the patients with available follow-up data, 49 out of 60 (81.7%) were still using the implant at 12 months, 29 out of 53 (54.7%) at 24 months, and 9 out of 40 (22.5%) at 36 months. The average time from tamoxifen prescription to implant removal was 12.1 months. Bothersome bleeding was the primary reason for ENG implant discontinuation (68.6%). No side effects from tamoxifen use were reported.

      Conclusion

      Tamoxifen was well-tolerated among this cohort of patients and can be considered a treatment option to manage bothersome implant bleeding in adolescents.

      Key Words

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      References

        • Funk S
        • Miller MM
        • Mishell DR
        • et al.
        Safety and efficacy of Implanon, a single-rod implantable contraceptive containing etonogestrel.
        Contraception. 2005; 71: 319-326
        View in Article

      2. Information. NexplanonPrescribingWest Orange, New Jersey, Organon USA, Inc, 2021. https://www.organon.com/product/usa/pi_circulars/n/nexplanon/nexplanon_pi.pdf.

        View in Article
        • Obijuru L
        • Bumpus S
        • Auinger P
        • et al.
        Etonogestrel implants in adolescents: experience, satisfaction, and continuation.
        J Adolesc Health. 2016; 58: 284-289
        View in Article
        • Deokar AM
        • Jackson W
        • Omar HA
        Menstrual bleeding patterns in adolescents using etonogestrel (ENG) implant.
        Int J Adolesc Med Health. 2011; 23: 75-77
        View in Article
        • Guazzelli CAF
        • de Queiroz FT
        • Barbieri M
        • et al.
        Etonogestrel implant in postpartum adolescents: bleeding pattern, efficacy and discontinuation rate.
        Contraception. 2010; 82: 256-259
        View in Article
        • Berlan E
        • Mizraji K
        • Bonny AE:
        Twelve-month discontinuation of etonogestrel implant in an outpatient pediatric setting.
        Contraception. 2016; 94: 81-86
        View in Article
        • Guiahi M
        • McBride M
        • Sheeder J
        • et al.
        Short-term treatment of bothersome bleeding for etonogestrel implant users using a 14-day oral contraceptive pill regimen: a randomized controlled trial.
        Obstet Gynecol. 2015; 126: 508-513
        View in Article
        • Mansour D
        • Bahamondes L
        • Critchley H
        • et al.
        The management of unacceptable bleeding patterns in etonogestrel-releasing contraceptive implant users.
        Contraception. 2011; 83: 202-210
        View in Article
        • Glasier AF
        • Wang H
        • Davie JE
        • et al.
        Administration of an antiprogesterone up-regulates estrogen receptors in the endometrium of women using norplant™: a pilot study.
        Fertil Steril. 2002; 77: 366-372
        View in Article
        • Fetih AN
        • Abbas AM
        • Kamel FA
        • et al.
        Tamoxifen for treatment of abnormal uterine bleeding in etonorgstrel implant users: a randomized clinical trial.
        Int J Reprod Contracept Obstet Gynecol. 2019; 8: 4462
        View in Article
        • Simmons K
        • Edelman A
        • Fu R
        • et al.
        A short course of tamoxifen reduces unscheduled bleeding in etonogestrel contraceptive implant users [24].
        Obstet Gynecol. 2016; 127: 9S
        View in Article
        • Simmons KB
        • Edelman AB
        • Fu R
        • et al.
        Tamoxifen for the treatment of breakthrough bleeding with the etonogestrel implant: a randomized controlled trial.
        Contraception. 2017; 95: 198-204
        View in Article
        • Cohen PA
        • Wang Y-.H
        • Maller G
        • et al.
        Pharmaceutical quantities of yohimbine found in dietary supplements in the USA.
        Drug Test Anal. 2016; 8: 357-369
        View in Article
        • Mourits MJ
        • De Vries EG
        • Willemse PH
        • et al.
        Tamoxifen treatment and gynecologic side effects: a review.
        Obstet Gynecol. 2001; 97: 855-866
        View in Article
        • Edelman AB
        • Kaneshiro B
        • Simmons KB
        • et al.
        Treatment of unfavorable bleeding patterns in contraceptive implant users: a randomized controlled trial.
        Obstet Gynecol. 2020; 136: 323-332
        View in Article
        • Mansour D
        • Korver T
        • Marintcheva-Petrova M
        • et al.
        The effects of Implanon on menstrual bleeding patterns.
        Eur J Contracept Reprod Health Care. 2008; 13: 13-28
        View in Article
        • Berenson AB
        • Tan A
        • Hirth JM:
        Complications and continuation rates associated with 2 types of long-acting contraception.
        Am J Obstet Gynecol. 2015; 212 (e1-8): 761
        View in Article

      18. Management of women with bleeding irregularities while using contraception [internet]. 2017. Available: http://www.cdc.gov/reproductivehealth/unintendedpregnancy/usspr.html. Apr 14 2021.

        View in Article
      19. ACOG Committee Opinion No. 735: adolescents and long-acting reversible contraception: implants and intrauterine devices.
        Obstet Gynecol. 2018; 131: e130-e139
        View in Article
      20. Practice Bulletin No. 186 Summary: long-acting reversible contraception: implants and intrauterine devices.
        Obstet Gynecol. 2017; 130: 1173-1175
        View in Article

      21. World Health Organization: Selected practice recommendations for contraceptive use (third edition). [Internet]. 2016. Available: https://www.who.int/reproductivehealth/publications/family_planning/SPR-3/en/.Apr 21 2021.

        View in Article
        • Abdel-Aleem H
        • d'Arcangues C
        • Vogelsong KM
        • et al.
        Treatment of vaginal bleeding irregularities induced by progestin only contraceptives.
        Cochrane Database Syst Rev. 2013; CD003449
        View in Article

      23. Clinical Effectiveness Unit (CEU) F of S& RH. FSRH Guideline Progestogen-only Implant. 202; Available: https://www.fsrh.org/standards-and-guidance/documents/cec-ceu-guidance-implants-feb-2014/. Apr 22 2021.

        View in Article

      24. Faculty of Sexual & Reproductive Healthcare (FSRH): Problematic Bleeding with Hormonal Contraception. 2015; Available from: http://04/FSRH/Problematic Bleeding/2015. Apr 22 2021.

        View in Article

      25. United States Food and Drug Administration: Nolvadex (tamoxifen citrate) package insert. 2018

        View in Article

      Article info

      Publication history

      Published online: November 12, 2021
      Accepted: November 1, 2021
      Received in revised form: October 27, 2021
      Received: August 10, 2021

      Footnotes

      Presentations: Findings presented at the North American Pediatric Adolescent Gynecology Conference, March 2021.

      Declaration of Competing Interest: The authors have no conflicts of interest to disclose.

      Identification

      DOI: https://doi.org/10.1016/j.jpag.2021.11.001

      Copyright

      © 2021 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

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