Implantation of pure crystalline pellets of estradiol for conception control

Abstract

Estradiol pellet implantation for contraception offers another alternative in conception control. The occurrence of only two pregnancies in 1,668 cycles (Pearl index: 1,42) reflects its efficacy. The advantages over oral contraceptives are: (1) absence of gastrointestinal symptoms, (2) minimal untoward effects, (3) no patient failure, and (4) convenience. Progressive stepdown in dose reduces the total amount of steroid used in long-term contraception. Contraceptive effect may not occur during the first month of implantation; adequate precaution should be taken. Because of the efficacy, minimal untoward side effects, and excellent patient acceptability, this regimen may be considered for contraception in developing countries and when other modalities are contraindicated.

PIP: A study was undertaken of the implantation of 4, 3, 2, and 1 pure crystalline pellets of estradiol at 6-month intervals in 123 sexually active women. The patients were followed for 278 trials, 1668 cycles, or 128.3 woman-years. There was a lack of significant weight change and incidence of hypertension on the treatment. 5 of 9 patients with previous hypermenorrhea and 14 of 20 patients with premenstrual headaches improved during therapy. The side effects of the treatment included headache in 1, hypermenorrhea in 9, breast tenderness in 7, and mild fluid retention in 15 patients. There were 4 pregnancies in the series, 2 occurring within the 1st month of implantation.