Vaginal bleeding patterns in Nigerian users of nomegestrol acetate subdermal contraceptive implant

Abstract

A 12 months longitudinal study was carried out in 214 consecutive Nigerian women using Nomegestrol acetate subdermal contraceptive implant (Uniplant R ) for the first time to establish the rates of different vagina l bleeding patterns according to WHO bleeding/spotting classification, and to assess their relationship with Uniplant discontinuation. The results showed an initial rise in t h e number of women experiencing altered vagina l bleeding which continued to fall towards the 12th month of use (57.01 % vs 26.17%). Similarly, a significant increase in mean menstrua l cycle length occurred in the first trimester of use and this disappeared by the third trimester. The mean numbers of bleeding/spotting days and bleeding/spotting free intervals increased significantly from first trimester to the fourth trimester. No change w a s noted in the mean number of bleeding/spotting episodes throughout the follow up period. The total discontinuation rate was 15.42%. Discontinuation on account of altered vaginal bleeding pattern was 3.27%. One accidental pregnancy occurred during follow up (Pearl index = 0.52). No significant change in haemoglobin levels w a s noted in the women. It was concluded that changes in menstrua l patterns in UniplantfR users occur mostly in the first six months of use and are unlikely to have any deleterious effects on the general health of the users.