Insertion and Removal of Implanon

CHAPTER 147 Insertion and Removal of Implanon

Implanon is an implantable contraceptive device that functions like other progestin-based contraceptives by developing a thick, hostile cervical mucus and eventual atrophy of the uterine endometrium. Compared to the original Norplant System, Implanon appears to cause a greater inhibition of ovulation in patients. Implanon is designed as a single implant measuring 4 cm long with a diameter of 2 mm and an outer structural membrane composed of ethylene vinyl acetate (EVA) copolymer (Fig. 147-1). This copolymer outer membrane may not react with the surrounding tissue as much as Norplant did, leading to less tissue fibrosis; thus permitting easier extraction when its content is exhausted. The implant core contains 68 mg of etonogestrel in EVA. The progestin is released initially at the rate of 60 µg/day in weeks 5 to 6 of use and then decreases to 35 to 45 µg/day at the end of the first year. The released amount of etonogestrel continues to decrease to 30 to 40 µg/day and 25 to 30 µg/day at 2 and 3 years of use, respectively. Implanon is effective for 3 years and has a shelf life of 5 years. The implant is placed in the subcutaneous tissue of the upper arm with a 19-gauge disposable, preloaded inserter. The insertion is a minor surgical procedure performed in the office. Implanon was approved in July 2006 by the U.S. Food and Drug Administration (FDA).

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May 14, 2017 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Insertion and Removal of Implanon

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