Ovarian cysts in users of Implanon and Jadelle subdermal contraceptive implants.
OBJECTIVE
To evaluate the prevalence of ovarian cysts in users of two contraceptive implants compared to users of intrauterine contraceptive (IUC).


METHODS
A total of 344 women were enrolled at 3 months of use of the etonogestrel-releasing implant (Implanon), the levonorgestrel-releasing implant (Jadelle) or the TCu380A IUC. Bimanual pelvic examination and vaginal ultrasound were performed during routine 3-, 6- and 12-month visits of asymptomatic women. Women with ovarian cysts (or enlarged ovarian follicles > or = 25 mm) were assessed weekly until disappearance or reduction of the image [including estradiol (E2) and progesterone (P) measurement], and women with no ovarian enlargement underwent the same evaluation for the same period of time.


RESULTS
Ovarian cysts were detected in 5.2%, 13.0% and 1.9% of users of Implanon, Jadelle and IUC, respectively, at 3 months. At 6 months of use, prevalence was 7.2%, 8.0% and 2.1%, whereas 12-month rates were 26.7%, 14.6% and 1.2% in the three groups, respectively. E2 levels were significantly higher among users with ovarian cysts than controls. The time until disappearance of the ovarian cyst was similar in all three groups. There were more cases of menorrhagia in users of implants who had ovarian cysts than in those with no ovarian enlargement.


CONCLUSIONS
The finding of ovarian cysts or enlarged ovarian follicles during the first year of use of Implanon and Jadelle implants is common and transient and should not be interpreted as a pathologic ovarian cyst. No further medical interventions are necessary.
Hidalgo
Maria Margarete
MM
Human Reproduction Unit, Department of Obstetrics and Gynecology, School of Medicine, Universidade Estadual de Campinas (UNICAMP), 13084-971, Campinas, SP, Brazil.
Lisondo
Claudio
C
Juliato
Cássia Teatin
CT
Espejo-Arce
Ximena
X
Monteiro
Ilza
I
Bahamondes
Luis
L
D000328:Adult; D016022:Case-Control Studies; D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000009:adverse effects*; D004343:Drug Implants; D005260:Female; D006801:Humans; D007434:Intrauterine Devices; D010048:Ovarian Cysts / Q000139:chemically induced*; D011372:Progestins / Q000008:administration & dosage / Q000009:adverse effects*; D011446:Prospective Studies
D003271:Contraceptive Agents, Female; D004343:Drug Implants; D011372:Progestins