Subdermal Contraceptive Implants: Work Mechanisms and Effectiveness

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Contraceptive methods have increasingly gained popularity over the last decade. They are perceived as one of the most effective ways to prevent unplanned pregnancy, and for this reason, they have massively gained acceptability among women. This paper discusses the subdermal contraceptive implant, exemplifies how it works, and provides statistical evidence of its effectiveness. Some of the most common contraceptive implants are Implanon, Norplant, and Jadelle. Implanon has a core containing 68mg of progesterone (etonogestrel) and an outer membrane composed of ethylene-vinyl acetate (EVA) (Moray, Chaurasia, Sachin, & Joshi, 2021). The inserts function by increasing serum levels of progesterone, which sequentially inhibits ovulation and increases the thickness of cervical mucus.

Progesterone prevents ovulation by inhibiting the development of the Graafian follicles in the ovary. According to Moray et al. (2021), an increase in etonogestrel results in negative feedback to the hypothalamus preventing the release of gonadotropin-releasing hormone (GRH). Reduced GRH levels subsequently decrease the secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) needed for the maturation and release of the ovum. Progesterone also increases cervical mucuss viscosity and leukocyte concentration, rendering it impermeable to sperm (Moray et al., 2021). Thick mucus prevents the passage of spermatozoa from the cervix to the uterus, thus averting fertilization. This contraceptive effect is short-lived as mucus reverts to its normal state of fluidity (Moray et al., 2021). Empirical research demonstrates that the subdermal implant is 99% effective, with 94-99% bioavailability (Moray et al., 2021). Hormones are excreted via the urinary and fecal route, thus preventing complications associated with progesterone excess. Researchers continue to employ innovative methods to improve subdermal implants; nevertheless, they are one of the safest and most effective birth controls available.

Reference

Moray, K. V., Chaurasia, H., Sachin, O., & Joshi, B. (2021). A systematic review on clinical effectiveness, side-effect profile and meta-analysis on continuation rate of etonogestrel contraceptive implant. Reproductive Health, 18(1). Web.

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