Users’ perspectives on Implanon in Malaysia, a multicultural Asian country

Abstract

Background:The primary objective of this study was to evaluate Malaysian women's perception, acceptance, and views on Implanon ® as a contraceptive method. We also aimed to identify women who favor Implanon, their vaginal bleeding patterns, nonmenstrual adverse events, reasons for discontinuation, and effect of Implanon on breastfeeding. Study design: This study followed up 140 women after insertion of Implanon at the University of Malaya Medical Centre by examination of their medical records and telephone interviews. User profile, discontinuation rate, reasons for choice of Implanon, discontinuation, menstrual and nonmenstrual side effects, and satisfaction rate were assessed. Results: The average age of users was 34.7 years, and 94.2% were para 2 and above. The ethnic distribution of the women reflected that of the general Malaysian population. The majority had at least secondary education (94.2%), with 41.2% having a higher degree. All of the users reported that they chose Implanon because it does not need compliance, and 72.1% felt that Implanon was cost-effective in the long term. Most users (70%) reported irregular menses and this was the main reason given for discontinuation. The vast majority reported an overall decrease in menstrual blood loss. Almost half (46%) suffered prolonged bleeding/spotting, and infrequent bleeding was experienced by 71 users (50.7%). Half of the women did not experience any nonmenstrual adverse events. The commonest complaint was weight gain, with the next most common complaints being hair loss, acne, headache, nausea, mood swings, and reduced libido. Most of the nursing mothers denied a reduction in breast milk. There was a high mean satisfaction score with Implanon. Conclusion: Implanon is well accepted by Malaysian women despite a high incidence of irregular bleeding which was found to be a major concern among women who discontinued the implant.

Implanon Discontinuation Rate and Associated Factors among Women who ever Used Implanon in the Last Three Years in Debre Markos Town, Northwest Ethiopia, 2016, Cross Sectional Study

“…This rate is consistent with the study conducted in Australia where 47% [17]of women using the implant discontinued within three years. However, it is higher than the study conducted in Nigeria, Egypt and Malaysia where the overall Implanon discontinuation rateswere 26.1%, 28% and 22.86% respectively [7,18,19]. Similarly, the rates of discontinuation at 6months, 12 months and 24 months were 10.5%, 23.9% and 38.2% which is higher than discontinuation rate observed in the above studies.…”

“…Studies conducted in Ofla district of Tigray region and Arsi zone of Oromia region, Ethiopia, were carried outin rural areas and majority of the participants (70%) have no formal education, and the remaining30 % were primary and secondary school [16,29]. On the other hand, studies conducted in Nigeria, Malaysia, America and Australia indicatedthat themajority of the participants (66%) were college and above while only a few of them were illiterate [6,7,18,27]. However, the participants of this study have differenteducational levels which range from no formal education (39.5%) to college and above levels(29.6%).…”

Knowledge, attitude and utilization of sub-dermal birth control implants among married rural women of Pakistan

“…But those who used it were satisfied. 23 The similar study reported that 72.1% of women were satisfied with Implant and for them it was a long term cost-effective method of contraception. Contrary to this another study conducted by Wong RC, et al making comparison of women using two different forms of long-term reversible contraception showed that there was more dissatisfaction amongst the Implant (60.9%) than the IUD users (17.2%).…”

“…The reason is that most of them at this age have at least one to two children and women then want birth spacing. 8,13,18,[21][22][23] Our study results reveal that knowledge of the participants about at least one method was 80% but only 26% of all women had used it. Only seven of these 26% women (i.e; only 21%) had used Implant.…”

“…Contrary to this another study conducted by Wong RC, et al making comparison of women using two different forms of long-term reversible contraception showed that there was more dissatisfaction amongst the Implant (60.9%) than the IUD users (17.2%). 18,16,[21][22][23] The current study observed that Reproductive Health Service (RHS-A) centre was most common source for getting knowledge about contraceptives followed by a family planning clinic and the lady health visitor. These three play a key role in acceptance or discontinuation of a method of family planning.…”