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. 2021 Feb;34(1):33-39.
doi: 10.1016/j.jpag.2020.08.017. Epub 2020 Sep 9.

Twelve-month Continuation of the Etonogestrel Implant in Adolescents With Polycystic Ovary Syndrome

Eliza Buyers  1 , Amy E Sass  2 , Cameron D Severn  3 , Laura Pyle  4 , Melanie Cree-Green  5
Affiliations

Twelve-month Continuation of the Etonogestrel Implant in Adolescents With Polycystic Ovary Syndrome

Eliza Buyers et al. J Pediatr Adolesc Gynecol. 2021 Feb.

Abstract

Study objective: To identify why adolescents with polycystic ovary syndrome (PCOS) chose the etonogestrel (ENG) contraceptive implant, to determine the 12-month continuation rate, and to characterize factors related to discontinuation.

Design, setting, and participants: Retrospective chart review of adolescents seen at a tertiary care children's hospital between July 1, 2008, and August 30, 2019, with PCOS diagnosis confirmed per National Institutes of Health criteria and ≥12-month ENG follow-up.

Interventions and main outcome measures: Demographic characteristics, reasons for ENG insertion and removal, and information on other hormonal/contraceptive therapies were collected. Patients were categorized as ENG continuers (use ≥12 months) or discontinuers (removal at <12 months), and groups were compared.

Results: A total of 96 patients met inclusion criteria (age 17.7 ± 2.2 years, body mass index 34.8 ± 8 kg/m2). Reasons for ENG were documented in 74% (51% contraception, 32% ease of use, 15% other, 13% estrogen avoidance). In all, 27% had never been sexually active, and 67% had had prior sexual activity. Treatments prior to ENG placement included 74% combined hormonal contraception, 20% medroxyprogesterone acetate withdrawal, and 17% depot medroxyprogesterone. A total of 77% continued ENG at 12 months. The main reasons for discontinuation were bleeding (41%), concern about weight gain (23%), and mood changes (18%). No preimplantation characteristics were independently predictive of continuation, although 100% of patients with type 2 diabetes (n = 11) continued. Patients who sought additional care, including telephone calls (41% vs 12%, P = .006) and clinic visits (64% vs 20%, P < .001) were more likely to discontinue.

Conclusions: The ENG implant was well tolerated in adolescents with PCOS and similar to published 12-month continuation rates.

Keywords: Adolescent; Contraceptive implant; Polycystic ovary syndrome.

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