For women who find daily birth control pills inconvenient, implantable contraceptives may be a new solution to their problems.
A contraceptive rod called Implanon was approved by the Food and Drug Administration last month, making the implant available to American women in the near future.
The 1.5-inch rod, inserted into the upper arm, works by releasing a type of progesterone hormone called etonogestrel over a period of three years, said Anita Nelson, a professor and doctor at Harbor UCLA Medical Center.
The rod can only be administered by trained professionals and the cost has not yet been determined.
“The goal is to suppress ovulation and thicken cervical mucus so the sperm can’t reach the egg,” Nelson said. “The prevention of fertilization should make people very comfortable.”
Compared to other contraceptive methods such as the birth control pill, which has to be carefully taken each day at the same time to achieve a 92 percent success rate, Implanon is more effective – it has a 99 percent protection rate, said Ram Parvataneni, an assistant professor at the UCLA Department of Obstetrics and Gynecology.
“In the U.S. study from which FDA approval was obtained, no pregnancies were reported,” Parvataneni said. “It is very effective, even more so than sterilization.”
The reason for such high success is that it does not require daily attention or maintenance, but acts on its own.
“Implanon is so important because once it is inserted, it is independent of user compliance,” he said.
Though Implanon has been shown to be effective in birth control, it, like birth control pills, does nothing to prevent sexually transmitted diseases, Nelson said.
“It’s difficult to make something that will address the problems of both contraception and STDs without sacrificing the quality of either one,” said Nelson. “I think of it as a package deal. Condoms and contraceptive devices should be used together.”
Implanon does have side effects, the main one being irregular vaginal bleeding, Nelson said.
“Some people will have excessive bleeding and others won’t have periods at all,” she said. “As off-putting as that sounds, it’s amazing how many women kept it in because their trust in it outweighed the inconvenience.”
Other, less common side effects include headaches and depression.
“Most women probably will not react to etonogestrel, but there will be a proportion of women who are at risk for emotional side effects,” said Andrea Rapkin, a professor at the UCLA Department of Obstetrics and Gynecology.
Despite these drawbacks, experts say Implanon is safe because it releases only progesterone and not estrogen. Estrogen, contained in birth control pills, causes most of the pill’s side effects, such as problems in blood clotting, said Angela Chen, a family planning specialist at the UCLA Department of Obstetrics and Gynecology.
Organon, the company producing Implanon, has eliminated problems associated with other contraceptive methods as well, including a previous implant called Norplant. Norplant consisted of six rods but was discontinued in the United States in 2000 due to overselling without training providers fast enough, as well as injuries during removal.
The presence of only one rod will allow for 1-minute insertions and 2-minute removals, while widespread efforts to train providers will increase competence, Nelson said.
“I can’t prescribe Implanon unless I’m trained for it first,” she said. “Training is not just about how to put the rod in. It’s also about the counseling that must be given to the patients.”
Organon will start training providers at the end of the month, and Implanon will not be widely available until the middle of next year, said Parvataneni.
The price for Implanon has not yet been determined.
“They’re bringing Implanon into the community with a slow domino effect,” Nelson said. “Patients will absolutely love it, and there’s a huge potential for popularity among college students because of their chaotic lifestyle.”