Factors Associated with Removal for Bothersome Bleeding in t
Hormonal pills can temporarily improve the side effect of breakthrough bleeding on the etonogestrel implant. The aims of this study were to determine demographic factors that are associated with bothersome bleeding and to evaluate the impact of prescribing temporizing measures on implant continuation.

A chart review was conducted on 1200 patients ages 12 to 24 years who received the implant in 2016. The primary outcome measure was removal of the implant within the first year of use. Researchers followed each patient for one year to determine rates of removal, reasons for removal, and temporizing measures prescribed for bleeding.

--Younger age and lower body mass index were associated with reporting bothersome vaginal bleeding.

--Patients who were nulliparous or had bothersome bleeding were more likely to have the implant removed in the first year.

--Patients who received a temporizing measure for bleeding were more likely to retain the implant for 1 year than those who did not receive one (67.1% vs. 40%).

Finally, certain individuals are more prone to report bleeding difficulties or to have the implant removed after placement in the first year. Timing methods for controlling annoying vaginal bleeding may be prescribed in the first year to reduce the rate of removal.

Source: https://www.jpagonline.org/article/S1083-3188(21)00213-8/fulltext?rss=yes