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Amanda Estrada posted Jun 4, 2020 1:00 AM

The implant is a progestin only contraception. It is a thin silicone rod that is inserted subdural under the upper arm. The rod contains a progestin that is released into the body over 3 years. The current implant on the US market, Nexplanon, is 4 cm long and 2mm in diameter. The implant is radiopaque and can be located by X-ray, CT, ultrasound, and MRI. Nexplanon works by suppressing ovulation, altering endometrial structure, and changing cervical mucus. Nexplanon has a 0.1% failure rate. The implant is easy to use, discrete, and reversable. It also relieves dysmenorrhea and endometriosis symptoms. Women may face disadvantages such as abnormal bleeding, ovarian cysts, increased risk of DVTs, and infection at the insertion site. the implant does not protect against STDs. The implant is contraindicated in women with DVTs, PE, hepatitis, severe cirrhosis, current or past breast cancer, liver tumors, lupus, and unexplained vaginal bleeding. The implant can be inserted at any time as long as the patient is not pregnant (Schadewald, 2020). According to the U.S. Selected Practice Recommendations for Contraceptive Use (2017), among healthy women, no examinations or tests are needed before initiation of an implant. There is no restriction for the use of the implant for women between menarche to 45 years of age (Classifications for Progestin-Only Contraceptives, 2020). The cost of Nexplanon can be up to $1,300 but, it is usually is free or low depending on health insurance, Medicaid, and with other government programs.

When helping patients decide on the best contraception method it is important to get to know them. A full health history is important to make sure any contraindications can be identified before starting the wrong method. Lifestyle is also a big factor. Will they be able to take a pill everyday or an injection every 12 weeks? Revertability should also be discussed. Is sterilization an option? Is there a possibility of wanting children in the near future? For example, a woman that is done having kids might be interested in the ParaGard IUD that lasts up to 10 years. While a young 26-year-old single girl may want a Skyla IUD that lasts for 3 years (Schadewald, 2020).

Schadewald, D. M., Pritham, U. A., Youngkin, E. Q., Davis, M. S., & Juve, C. (2020). Womens health: a primary care clinical guide. Hoboken, NJ: Pearson Education, Inc.

Classifications for Progestin-Only Contraceptives. (2020). Retrieved from https://www.cdc.gov/reproductivehealth/contraception/mmwr/mec/appendixc_tableC1.html

U.S. Selected Practice Recommendations for Contraceptive Use. (2017). Retrieved from https://www.cdc.gov/mmwr/volumes/65/rr/rr6504a1.ht…

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