title: Nomegestrol acetate contraceptive implant use by women with sickle cell disease.
abstract: OBJECTIVE
  To assess the contraceptive effectiveness, safety, and potential health benefits of nomegestrol acetate contraceptive implant use by women with homozygous sickle cell disease (hemoglobin SS).
  
  
  METHODS
  This was a prospective observation before and after insertion of nomegestrol acetate of 20 women with sickle cell disease (test group) compared with 10 women with similar sociodemographic backgrounds. Changes in hematologic and biochemical parameters and symptoms of sickle cell crisis were measured during 12 months of observation.
  
  
  RESULTS
  After use of nomegestrol acetate for 1 to 9 months, the women in the test group had symptomatic improvement, with no crisis that required hospitalization and no deaths. Sickle cell symptoms persisted in the women in the control group, with 1 recorded death. Increases in F-cell and fetal hemoglobin parallel the observed clinical improvement in the treated women. There were no adverse hematologic or biochemical changes associated with the use of nomegestrol acetate implants.
  
  
  CONCLUSIONS
  Nomegestrol acetate appears to be a safe and appropriate contraceptive for women with sickle cell disease, showing evidence of being a "stimulant" for F-cell reactivation, independent of F hemoglobin total production increase.
authors.affiliation: Hospital Edgard Santos, Federal University of Bahia, Salvador, Brazil.
authors.forename: M de L
authors.initials: Mde L
authors.lastname: Nascimento
authors.forename: O A
authors.initials: OA
authors.lastname: Ladipo
authors.forename: E M
authors.initials: EM
authors.lastname: Coutinho
mesh_terms: D000328:Adult; D000755:Anemia, Sickle Cell / Q000097:blood; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D008535:Megestrol; D009649:Norpregnadienes / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D045167:Progesterone Congeners / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D009649:Norpregnadienes; D045167:Progesterone Congeners; C038501:nomegestrol acetate; D008535:Megestrol