12-month Continuation of the Etonogestrel Implant in Adolesc
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Adolescents with Polycystic Ovary Syndrome (PCOS) chose the etonogestrel (ENG) contraceptive implant, determine the 12-month continuation rate, and characterize factors related to discontinuation.

Retrospective chart review of adolescents between July 1, 2008, and August 30, 2019, with PCOS diagnosis confirmed per NIH criteria and 12-month ENG follow-up. Demographic characteristics, reasons for ENG insertion and removal, and information on other hormonal/contraceptive therapies were collected. Patients were categorized as ENG continuers (use more than 12 months) or discontinuers (removed less than 12 months) and groups were compared.

Ninety-six patients met the inclusion criteria. The reasons for ENG were documented in 74%. 27% had never been sexually active and 67% had prior sexual activity. Treatments prior to ENG placement included 74% combined hormonal contraception, 20% medroxyprogesterone acetate withdrawal and 17% depot medroxyprogesterone. 77% continued ENG at 12 months. The top reasons for discontinuation were bleeding (41%), concern for weight gain (23%), and mood changes (18%). No pre-implant characteristics were independently predictive of continuation, although 100% of patients with type 2 diabetes continued. Patients who sought additional care including phone calls (41% vs 12%) and clinic visits (64% vs 20%) were more likely to discontinue. ENG implant was well tolerated in adolescents with PCOS and was similar to published 12-month continuation rates.