COMPARISON OF BLEEDING PATTERNS WITH REPLACEMENT VERSUS EXTENDED USE OF THE CONTRACEPTIVE IMPLANT

Objectives

We aimed to compare bleeding days and spotting days and satisfaction among individuals who replaced their contraceptive implant at three years versus those who extended use of the implant past three years.

Methods

We conducted a prospective cohort study. Participants reported number of bleeding and spotting days for 30 days prior to their implant appointment, decided to replace (replacers) or extend (extenders) use, and then reported number of bleeding and spotting days for 30 days after. Participants also recorded their satisfaction with the amount of bleeding and/or spotting. We used Wilcoxon Rank Sum tests to compare unadjusted median differences between groups and multivariable median (quantile) regression to adjust for co-variates.

Results

Among 52 participants, there was no significant difference between the two groups 30 days before or 30 days after replacing or extending use of the implant for spotting only days (0 vs 0, p=1.00) or any bleeding days (0 vs. 0, p=0.39). There were more spotting days 30 days prior to the appointment among those who decided to replace their implant, however the difference was not statistically significant (2 vs. 1, p=0.06). We found no statistically significant differences in median number of days reporting satisfaction with bleeding/spotting patterns from before and after 30 days (0 vs. -1, p=0.85).

Conclusions

Neither implant replacers nor extenders experienced significant changes in bleeding 30 days before or after replacing or extending. This data can help clinicians counsel patients regarding bleeding patterns when they are deciding to keep or replace their contraceptive implant at three years.