Nexplanon Subdermal Implant: Assessment of Sexual Profile, Metabolism, and Bleeding in a Cohort of Italian Women

Abstract

Objectives: To evaluate the impact on metabolism, bleeding, and sexual function of Nexplanon, a subdermal implant.

Study design: We recruited women (n=101) receiving the Nexplanon implant at two university centers in Italy between 2011 and 2016 into this prospective, observational, multicenter research trial. Participants completed the Interview for Ratings of Sexual Function (IRSF) and the Female Sexual Function Index (FSFI) questionnaires before and 3 and 6 months after the implant was inserted. In addition, all blood parameters were assessed at these visits. All women were given a menstrual diary card and a pictorial blood assessment chart to record daily any vaginal bleeding.

Results: The studied metabolic parameters remained in the normal range, showing no alarming modifications: minimal statistical reductions (in aspartate aminotransferase, alanine aminotransferase, total cholesterol, triglycerides, and activated partial thromboplastin time) and increases (in glucose and prothrombin activity) were observed. Changes in IRSF score over 6 months showed a significant increase in pleasure, personal initiative, orgasm, intensity of orgasm, and satisfaction, and a significant decrease in anxiety and discomfort. Mean Body Mass Index decreased, and the weekly frequency of sexual intercourse increased.

Conclusions: Nexplanon showed not only a lower metabolic and bleeding impact, but also important positive effects on sexual function. It expands the range of possibilities for women, 38 and couples, in the modern concepts of sexual and reproductive wellbeing.

Figure 1

Study flowchart.

Figure 2

Effects on sexual function in terms of ΔVAS at 6 months (VAS6) after insertion. The evaluation was performed for each item investigated through the Interview for Ratings of Sexual Function (IRSF) questionnaire.

Figure 3

Total Female Sexual Function Index (FFSI) score at recruitment and 3 and 6 months after insertion of Nexplanon. Data are expressed as mean (minimum to maximum).

Figure 4

Metabolic parameters were evaluated before implant insertion (MET0) and 3 months (MET3) and 6 months (MET6) after implant. For each parameter measured, we calculated the difference (ΔMET) at three different times: ΔMET1 = MET3–MET0; ΔMET2 = MET6–MET0; ΔMET3 = MET6–MET3. Data are expressed as mean ± SD.