1) Analyze the discontinuation rates of progesterone implants (PIs), 2) assess the effect of age, race, parity, and BMI on continuation, and 3) assess the use of hormone therapy for PI-associated irregular bleeding.METHODS:
This was a single center retrospective chart review of adolescents (10–19 years) and women aged 20–45 years who had PIs inserted for contraception from 2010 to 2014.RESULTS:
Five hundred charts were reviewed, and 303 patients were included in our analysis. The mean discontinuation rate at 1 year was 31.5% for adolescents, 32.7% for 20–24 year olds and 30.5% for 25–45 year olds. The mean discontinuation time for adolescents was 17.6 months (SD 11.7), 12.6 months (SD 9.95) for 20–24 year olds and 13.3 months (SD 11.8) for 25–45 year olds. There were no significant differences in continuation rates based on age, race, parity, or BMI (ANOVA). The most commonly reported cause of discontinuation was irregular bleeding (46.8%) followed by weight gain and mood swings. Amongst patients with irregular bleeding, hormone therapy (low dose estrogen or OCPs) was offered to 47% of adolescents and 25.9% of adults. Of those treated, 45% reported an overall improvement in symptoms. OB/GYN residents were less likely to initiate medical therapy compared to non-resident physicians.CONCLUSION:
Due to irregular bleeding, PIs have a high discontinuation rate in both adolescents and adults. Implant continuation is not effected by age, race, parity or BMI. However, hormonal therapy can provide effective relief of irregular bleeding in some patients.