The management of unacceptable bleeding patterns in etonogestrel-releasing contraceptive implant users.


:The aim of this guidance is to review the management of unacceptable vaginal bleeding patterns in etonogestrel (ENG)-releasing contraceptive implant users concentrating, where possible, on the evidence for pharmacological treatments and identifying a pragmatic approach where this is not possible. This article was developed in accordance with methodology used for producing Royal College of Obstetricians and Gynaecologists' Green Top Guidelines. The Cochrane Library (including the Cochrane Database of Systematic Reviews, DARE and EMBASE) and Medline (1966-2010) were searched using the relevant MeSH terms, including all subheadings, and this was combined with a keyword search. Search words included "progestogen only contraceptives," "contraceptive implants," "progestogen implants," "etonogestrel implants," "irregular bleeding," "unpredictable bleeding," "bleeding irregularity" and "bleeding pattern," and the search was limited to humans and English language. Enquiries for relevant information were also made to the pharmaceutical industry and researchers for missing studies. Although this is not a systematic review, two of the authors (D.M., I.S.F.), qualitatively assessed those papers reporting quantitative results involving treatments given either to stop or prevent bleeding in ENG or levonorgestrel contraceptive implants users.






Mansour D,Bahamondes L,Critchley H,Darney P,Fraser IS




Has Abstract


2011-03-01 00:00:00














  • Clinicians' perceptions and provision of hormonal contraceptives for HIV-positive and at-risk women in Southern Africa: an original research article.

    abstract:OBJECTIVES:To assess clinician provision of hormonal contraception for HIV-positive and at-risk women in Southern Africa. STUDY DESIGN:We conducted a nationally representative survey of clinicians (n=1444) in HIV-prevalent settings in South Africa and Zimbabwe to evaluate evidence-based contraceptive care and clinicia...


    pub_type: 杂志文章


    authors: Blanchard K,Chipato T,Ramjee G,Nhemachena T,Harper CC,Provider Study Writing Comittee.

    更新日期:2014-10-01 00:00:00

  • Use of a radioreceptor test for HCG in women practicing contraception.

    abstract::The importance of a simple, rapid and highly sensitive test for the diagnosis of early pregnancy cannot be overemphasized. In the present times when newer delivery systems of contraceptive agents and menstrual regulation procedures are increasingly used for fertility regulation, it is inevitable that confirmation of e...


    pub_type: 杂志文章


    authors: Shahani SM,Kulkarni PP,Patel KL

    更新日期:1978-11-01 00:00:00

  • A survey of prescribing habits for high-estrogen oral contraceptives.

    abstract::A simple survey was made of health-care providers to determine their attitudes toward oral contraceptives containing more than 50 mcg of estrogen. It was found that about two-thirds of respondents prescribe this group of medication, although few do so regularly. Their use seemed correlated with providers 40 years of a...


    pub_type: 杂志文章


    authors: Grossman RA

    更新日期:1988-11-01 00:00:00

  • Ethinyl estradiol and levonorgestrel pharmacokinetics with a low-dose transdermal contraceptive delivery system, AG200-15: a randomized controlled trial.

    abstract:BACKGROUND:This study evaluated the ethinyl estradiol (EE) and levonorgestrel (LNG) pharmacokinetic profiles of AG200-15, a transdermal contraceptive delivery system, compared with a combination oral contraceptive (COC) containing EE 35 mcg and norgestimate 250 mcg. STUDY DESIGN:A Phase 1, open-label, single-center st...


    pub_type: 杂志文章,随机对照试验


    authors: Archer DF,Stanczyk FZ,Rubin A,Foegh M

    更新日期:2012-06-01 00:00:00

  • Continuation of copper-containing intrauterine devices at 6 months.

    abstract:BACKGROUND:Intrauterine devices (IUDs) are highly effective at preventing pregnancy and cost-effective. Suboptimal continuation of IUDs places women at risk of unintended pregnancy. Little is known about prevalence or predictors of discontinuation of IUDs within the first 6 months. STUDY DESIGN:A retrospective cohort ...


    pub_type: 杂志文章


    authors: Garbers S,Haines-Stephan J,Lipton Y,Meserve A,Spieler L,Chiasson MA

    更新日期:2013-01-01 00:00:00

  • Latex rubber condoms: predicting and extending shelf life.

    abstract::Condoms from five manufacturers were subjected to controlled exposures of heat, humidity, and air and to different natural environments in five countries. Under aerobic conditions (condoms in permeable packages or unpackaged), stress properties declined. The relationship between rate of decline as a function of temper...


    pub_type: 杂志文章


    authors: Free MJ,Srisamang V,Vail J,Mercer D,Kotz R,Marlowe DE

    更新日期:1996-04-01 00:00:00

  • Comparative multicentre trial of three IUDs inserted immediately following delivery of the placenta.

    abstract::A multinational comparative trial of three IUDs (Copper 7, Lippes loop size D and the Postpartum T) randomly inserted immediately following delivery of the placenta was conducted in six centres. A total of 841 women entered the study. As the predetermined termination indices for expulsions were exceeded at six months ...


    pub_type: 临床试验,杂志文章,随机对照试验



    更新日期:1980-07-01 00:00:00

  • Clinical performance of the TCu 380A and Lippes Loop IUDs in three developing countries.

    abstract::The clinical performance of the Copper T 380A (TCu 380A) and the Lippes Loop intrauterine devices (IUDs) were evaluated for 12 months in a group of 710 women who had one of the two IUDs inserted. Results are from a randomized clinical trial conducted at three collaborating research sites located in three developing co...


    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Farr G,Amatya R,Acosta M,Ekwempu C,Kisninci H

    更新日期:1995-07-01 00:00:00

  • Safety of intrauterine devices among women with HIV: a systematic review.

    abstract:BACKGROUND:Use of highly effective contraception among women living with HIV is critical to prevent unintended pregnancy and subsequent risk of maternal complications and perinatal HIV transmission. However, it is not known whether use of intrauterine devices (IUDs) among women with advanced HIV disease poses an increa...


    pub_type: 杂志文章,评审


    authors: Tepper NK,Curtis KM,Nanda K,Jamieson DJ

    更新日期:2016-12-01 00:00:00

  • Patterns of ovulation and bleeding with a low levonorgestrel-releasing intrauterine device.

    abstract::Patterns of bleeding and plasma concentrations of levonorgestrel, progesterone, estradiol, LH and FSH were studied in ten volunteers who had a levonorgestrel-releasing IUD inserted postmenstrually. The IUD was designed to release 12 microgram/day. All but two of the volunteers ovulated during treatment. The ovulatory ...


    pub_type: 杂志文章


    authors: Nilsson CG,Lähteenmäki P,Luukkainen T

    更新日期:1980-02-01 00:00:00

  • Interference with ovulation and luteal function by human ovarian follicular fluid peptide in bonnet monkeys, Macaca radiata.

    abstract::Partially purified human ovarian follicular fluid peptide (hGF2) was administered during follicular phase in 5 bonnet monkeys. In control as well as hGF2-injected animals, ovulation was synchronized by treatment with FSH, Pergonal and hCG. All the 5 control bonnet monkeys showed plasma estradiol peak followed by incre...


    pub_type: 杂志文章


    authors: Nandedkar TD,Shahid JK,Kholkute SD,Darpe MB,Moodbidri SB

    更新日期:1992-04-01 00:00:00

  • Cervical carcinoma in situ and use of depot-medroxyprogesterone acetate (DMPA). WHO Collaborative Study of Neoplasia and Steroid Contraceptives.

    abstract::The relationship of depot-medroxyprogesterone acetate (D-MPA) use to risk of cervical carcinoma in situ was investigated using data from a large multi-national, hospital-based case-control study. To avoid possible detection bias from Pap smear screening, final analyses were restricted to a subset of cases with symptom...


    pub_type: 杂志文章,多中心研究


    authors: Thomas DB,Ye Z,Ray RM

    更新日期:1995-01-01 00:00:00

  • Inhibition of progesterone-induced development of giant mitochondria in uterine glandular epithelial cells by an antiestrogen in rat.

    abstract::Effect of antiestrogen ormeloxifene on progesterone-induced development of giant mitochondria in uterine glandular epithelial cells in ovariectomized adult Sprague-Dawley rats was investigated. Antiestrogen tamoxifen and antiprogestin onapristone were used for comparison. Well-formed giant mitochondria were observed i...


    pub_type: 杂志文章


    authors: Chauhan SC,Singh MM,Maitra SC,Kamboj VP

    更新日期:1996-10-01 00:00:00

  • Use of cauda epididymis extract as immunocontraceptive.

    abstract::The objective of this study was to evaluate use of a cauda epididymis extract (CEE) as an immunocontraceptive in rats. Twenty-two rats in puberty or 19 rats that gave birth once (primipara) were immunized with intraperitoneal (IP) injection of CEE. Rats in puberty received one or two injections of CEE containing 1.5 x...


    pub_type: 杂志文章


    authors: Risvanli A,Aydin M,Kaygusuzoglu E,Bulut H,Apaydin AM,Timurkan H

    更新日期:2002-12-01 00:00:00

  • Reference value of semen quality in Chinese young men.

    abstract::The purpose of the study was to evaluate semen quality in young Chinese men and to establish reference values. Normal healthy young men from seven geographical areas were enrolled. The study showed that the mean sperm volume was 2.61 mL, and mean percent of sperm with forward progression was 59.89, while median of sem...


    pub_type: 杂志文章


    authors: Junqing W,Qiuying Y,Jianguo T,Wei Y,Liwei B,Yuxian L,Yumei Z,Kangshou Y,Weiqun L,Lu C,Ersheng G

    更新日期:2002-05-01 00:00:00

  • Music as an auxiliary analgesic during first trimester surgical abortion: a randomized controlled trial.

    abstract:BACKGROUND:Music has served as an auxiliary analgesic in perioperative settings. This study evaluates the impact of intraoperative music added to routine pain control measures during first trimester surgical abortion. STUDY DESIGN:We analyzed data from 101 women randomized to undergo abortion with routine pain control...


    pub_type: 杂志文章,随机对照试验


    authors: Guerrero JM,Castaño PM,Schmidt EO,Rosario L,Westhoff CL

    更新日期:2012-08-01 00:00:00

  • The effects of gossypol on nuclear protein in rat testes. II. The synthesis of histones and testis-specific proteins after gossypol treatment.

    abstract::This communication is to report the effects of gossypol on the synthesis of chromosomal basic proteins in the spermiogenic cells. A double-labelling experiment has been performed. The control rats received 14C-arginine, whereas the gossypol-treated rats received a 3H-arginine injection. An equal volume of the tissues ...


    pub_type: 杂志文章


    authors: Teng CS,Fei RR

    更新日期:1988-03-01 00:00:00

  • Associations of mental illness and substance use disorders with prescription contraception use among women veterans.

    abstract:OBJECTIVE:To investigate whether mental illness and substance use disorder (SUD) are associated with having a prescription contraceptive method among women veterans. STUDY DESIGN:We conducted a retrospective analysis of National Veterans Administration (VA) administrative and clinical data for women veterans aged 18-4...


    pub_type: 杂志文章


    authors: Callegari LS,Zhao X,Nelson KM,Lehavot K,Bradley KA,Borrero S

    更新日期:2014-07-01 00:00:00

  • Efficacy of nonhormonal vaginal contraceptives from a hydrogel delivery system.

    abstract::This investigation describes the synthesis of a biodegradable hydrogel composed of a core surrounded by four concentric sheaths containing dextran, copolymers of polylactide and epsilon-caprolactone. The hydrogel was impregnated with iron (II) d-gluconate dihydrate, which causes complete spermiostasis due to lipid per...


    pub_type: 杂志文章


    authors: Saxena BB,Singh M,Gospin RM,Chu CC,Ledger WJ

    更新日期:2004-09-01 00:00:00

  • Can we identify women at risk of pregnancy despite using emergency contraception? Data from randomized trials of ulipristal acetate and levonorgestrel.

    abstract:BACKGROUND:Emergency contraception (EC) does not always work. Clinicians should be aware of potential risk factors for EC failure. STUDY DESIGN:Data from a meta-analysis of two randomized controlled trials comparing the efficacy of ulipristal acetate (UPA) with levonorgestrel were analyzed to identify factors associat...


    pub_type: 杂志文章


    authors: Glasier A,Cameron ST,Blithe D,Scherrer B,Mathe H,Levy D,Gainer E,Ulmann A

    更新日期:2011-10-01 00:00:00

  • Effect of dose on the pharmacokinetics of levonorgestrel in the rat during the rapid elimination phase following subcutaneous administration.

    abstract::Adult female rats were given a single, subcutaneous injection of 8, 16 or 32 micrograms of levonorgestrel (LNG). Blood samples were collected at various time intervals and serum concentrations of LNG were determined by radioimmunoassay. The patterns of temporal decline in LNG concentrations in the three dose groups in...


    pub_type: 杂志文章


    authors: Naqvi RH,Mitra SB,Lindberg MC

    更新日期:1984-12-01 00:00:00

  • Comparative pharmacokinetic estimates of drospirenone alone and in combination with ethinyl estradiol after single and repeated oral administration in healthy females.

    abstract:OBJECTIVE:To determine the pharmacokinetics (PK) of drospirenone (DRSP), alone versus in combination with ethinyl estradiol (EE), after single and repeated administration. STUDY DESIGN:We conducted a single-centre, open-label, crossover, 2-treatment, 2-period, 2-sequence study in which non-micronized DRSP 4 mg or a co...


    pub_type: 杂志文章


    authors: Richter WH,Koytchev R,Kirkov V,Merki G,Colli E,Regidor PA

    更新日期:2020-02-01 00:00:00

  • Interaction between broad-spectrum antibiotics and the combined oral contraceptive pill. A literature review.

    abstract::There is considerable variation in opinion about the importance of drug interactions between the combined oral contraceptive pill (COCP) and broad-spectrum antibiotics. Clinical practice varies widely, especially between doctors in Europe and those in the US. Rifampicin and griseofulvin induce hepatic enzymes and do a...


    pub_type: 杂志文章,评审


    authors: Weaver K,Glasier A

    更新日期:1999-02-01 00:00:00

  • Mid-trimester abortion by vaginal administration of 9-deoxo-16, 16-dimethyl-9-methylene-PGE2.

    abstract::9-Deoxo-16, 16-dimethyl-9-methylene-PGE2 is a new prostaglandin analogue which is stable in suppository form. Estimates of potential for gastrointestinal side effects in monkey in vivo indicated that the frequency of diarrhea was low with retention of uterine stimulating potency. In the present study the effect of the...


    pub_type: 杂志文章


    authors: Bygdeman M,Christensen N,Gréen K,Lundström V

    更新日期:1980-08-01 00:00:00

  • Women's motivation to participate in contraceptive efficacy trials.

    abstract:BACKGROUND:We sought to determine whether there are differences in subject's motivation to participate in hormonal and barrier method contraceptive efficacy studies. STUDY DESIGN:All women presenting for screening appointments for either barrier or hormonal contraceptive efficacy trials were asked to complete a survey...


    pub_type: 杂志文章


    authors: Hohmann H,Reid L,Creinin MD

    更新日期:2009-09-01 00:00:00

  • A pilot clinical trial of ultrasound-guided postplacental insertion of a levonorgestrel intrauterine device.

    abstract:BACKGROUND:Postplacental intrauterine device (IUD) insertion is a safe, convenient and effective option for postpartum contraception. Few studies involve ultrasound-guided insertion, and none involve the levonorgestrel IUD or take place in the United States. STUDY DESIGN:The study was conducted to assess the safety an...


    pub_type: 临床试验,杂志文章


    authors: Hayes JL,Cwiak C,Goedken P,Zieman M

    更新日期:2007-10-01 00:00:00

  • Effect of polyphloretin phosphate on the contraceptive action of a polyethylene intrauterine device in rats.

    abstract::A polyethylene intrauterine device (IUD) inserted in one horn of the rat uterus on Day 2 of pregnancy prevented implantation in 9 out of 12 rats in the horn with the device. When polyphloretin phosphate (PPP), a substance known to inhibit alkaline phosphatase, was administered to such rats from Day 1 till Day 5 of pre...


    pub_type: 杂志文章


    authors: Chaudhury MR

    更新日期:1983-08-01 00:00:00

  • Inhibition by gossypol of cyclic AMP production in mouse Leydig cells.

    abstract::Gossypol has been shown to inhibit steroidogenesis in leydig cells. This study examined the mechanism of this action by investigating the effect of gossypol on leydig cell hCG receptor binding, adenylate cyclase activity and cyclic AMP production in leydig cells. Gossypol had no effect on hCG binding to cell membranes...


    pub_type: 杂志文章


    authors: Pearce S,Sufi SB,O'Shaughnessy PJ,Donaldson A,Jeffcoate SL

    更新日期:1986-12-01 00:00:00

  • Perfect-use and typical-use Pearl Index of a contraceptive mobile app.

    abstract:OBJECTIVES:The Natural Cycles application is a fertility awareness-based contraceptive method that uses dates of menstruation and basal body temperature to inform couples whether protected intercourse is needed to prevent pregnancies. Our purpose with this study is to investigate the contraceptive efficacy of the mobil...


    pub_type: 杂志文章


    authors: Berglund Scherwitzl E,Lundberg O,Kopp Kallner H,Gemzell Danielsson K,Trussell J,Scherwitzl R

    更新日期:2017-12-01 00:00:00

  • Restoring testosterone levels by adding dehydroepiandrosterone to a drospirenone containing combined oral contraceptive: I. Endocrine effects.

    abstract:OBJECTIVES:Combined oral contraceptives (COCs) decrease testosterone (T) levels. This study investigated restoration of T and other androgen concentrations during COC use by 'co-administration' of dehydroepiandrosterone (DHEA). STUDY DESIGN:In this randomized, double-blind, placebo-controlled study in 99 new COC start...


    pub_type: 杂志文章,随机对照试验


    authors: Zimmerman Y,Foidart JM,Pintiaux A,Minon JM,Fauser BC,Cobey K,Coelingh Bennink HJ

    更新日期:2015-02-01 00:00:00