Management of bleeding irregularities among etonogestrel implant users: Is combined oral contraceptives pills or nonsteroidal anti-inflammatory drugs the better option?

J Obstet Gynaecol Res. 2020 Mar;46(3):479-484. doi: 10.1111/jog.14195. Epub 2020 Jan 20.

Abstract

Aim: This study is to evaluate whether unacceptable bleeding among the etonogestrel implant user could be better alleviated using combined oral contraceptive pills (COCP) or nonsteroidal anti-inflammation drugs (NSAID).

Methods: This is a prospective randomized study for evaluation of 84 etonogestrel implant (Implanon) users with prolonged or frequent bleeding. They were assigned to either receiving a COCP containing 20 mcg ethinyl estradiol/150 mg desogestrel for two continuous cycle or NSAID; mefenamic acid 500 mg TDS for 5 days, 21 days apart for two cycles. Bleeding pattern during the treatment was recorded and analyzed.

Results: A total of 32 women (76.2%) in COCP group and 15 women (35.7%) in NSAID group stop bleeding within 7 days after the initiation of treatment which was statistically significant (P < 0.05). The mean duration of bleeding and spotting days in women treated with COCP was significantly lesser compared to NSAID group (7.29 ± 3.16 vs 10.57 ± 4.14 days (P < 0.05).

Conclusion: We conclude that COCP is more efficient compared to NSAID in managing bleeding irregularities among etonogestrel implant users.

Keywords: NSAID; bleeding irregularities; etonogestrel implant; hormonal treatment.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Contraceptive Agents, Female / therapeutic use*
  • Contraceptives, Oral, Combined / therapeutic use*
  • Desogestrel / therapeutic use*
  • Female
  • Humans
  • Metrorrhagia / drug therapy*
  • Prospective Studies

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Contraceptive Agents, Female
  • Contraceptives, Oral, Combined
  • etonogestrel
  • Desogestrel