Safety of implantable contraceptives for women: data from observational studies.
Contraceptive implants are registered in over 60 countries and have been used by millions of women for three decades. This article reviews findings from observational studies on the safety of contraceptive implants and examines the risk of specific health outcomes. Fifty-five articles were reviewed, and the body of evidence for each health outcome was summarized. Available evidence suggests that contraceptive implants are safe and, overall, implant users do not experience adverse events at rates higher than women not using implants. With respect to specific outcomes, the evidence suggests no increased risks of pelvic inflammatory disease, decreased bone mineral density, anemia, thrombocytopenia, or death with implant use. The evidence was too limited to draw meaningful conclusions for neoplastic disease, cardiovascular events, and HIV/AIDS. Nonsignificantly elevated associations were reported for diabetes, serious mental disorders, and rheumatoid arthritis. Conditions for which risks were marginally, yet significantly, elevated were hypertension and gall bladder disease.
Curtis
Kathryn M
KM
Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA. kmc6@cdc.gov
D015519:Bone Density / Q000187:drug effects; D015331:Cohort Studies; D003271:Contraceptive Agents, Female / Q000009:adverse effects*; D018849:Controlled Clinical Trials as Topic; D003920:Diabetes Mellitus / Q000139:chemically induced; D004343:Drug Implants; D005260:Female; D005705:Gallbladder Diseases / Q000139:chemically induced; D015658:HIV Infections / Q000139:chemically induced; D006402:Hematologic Diseases / Q000139:chemically induced; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D009026:Mortality; D009369:Neoplasms / Q000139:chemically induced; D019965:Neurocognitive Disorders / Q000139:chemically induced; D000292:Pelvic Inflammatory Disease / Q000139:chemically induced
D003271:Contraceptive Agents, Female; D004343:Drug Implants