Jordanian women's experience with etonogestrel subdermal contraceptive implant in two family planning clinics

Objective: Etonogestrel subdermal hormonal contraceptive implant (Implanon®) is a popular and effective contraceptive. However, some users discontinue it for a variety of reasons. To explore the experience of Jordanian women with Implanon. Methods: This survey was undertaken with 69 women who had used or were using Implanon. Data was obtained through telephone interviews and by examining the women's medical records. Results: The mean age of participants was 30.9 (± 4.99) years. All users had pre-insertion counseling by family planning nurses. No pregnancies occurred while on Implanon. At the time of the survey, 37 women had Implanon in situ and 32 women had Implanon removed due to side effects. Thus, the discontinuation rate was 46.4%. The main reason for discontinuation was bleeding problems. The other main reasons for removal were: weight gain (34.4%), mood change (50%), headache (34.4%), nausea (21.9%), reduced libido (40.6%), acne (15.6%) and hirsutism (3.1%). Of those who discontinued the implant (n=32), 20 women (40.8%) experienced a period duration of < 8 days compared to 12 women (60%) with periods > 8 days (Chi square 7.9, p value = 0.005). Moreover, 62% of current implant users reported higher satisfactory pre-insertion knowledge of the advantages and disadvantages than those who removed it (chi-square=5.12, p=0.024). Conclusions: The discontinuation rate of Implanon was rather high compared to other countries. The main reason for discontinuation was abnormal bleeding pattern. This is the first report about discontinuation rate of Implanon in Jordan.