title: Insertion and 3-year follow-up experience of 372 etonogestrel subdermal contraceptive implants by family physicians in Granada, Spain.
abstract: BACKGROUND
  User profile, continuation rate, reasons for discontinuation, problems during insertion and removal, and effectiveness of an etonogestrel subdermal contraceptive implant (ESCI) were assessed.
  
  
  METHODS
  A follow-up of 372 women 3 years after insertion of an ESCI performed by family physicians in Granada, Spain, by means of consultations, examination of medical records and telephone interviews.
  
  
  RESULTS
  Data were available for 356 (95.7%) women. The average age was 27.2 years, and 159 (42.7%) were nulliparous. Continuation rates were 91.0% at 1 year, 74.7% at 2 years and 65.1% at 2 years and 9 months. The main reasons for discontinuation were excessive bleeding (44, 12.4%), wish to become pregnant (44, 12.4%) and side effects not related to menstruation (21, 5.9%). However, 141 (39.6%) received a second implant when the first one expired. No pregnancy occurred in 893.4 women-years.
  
  
  CONCLUSIONS
  Family physicians can achieve excellent results with the ESCI. It should be included in the range of contraceptives offered by primary care physicians.
authors.affiliation: University Health Centre of La Chana, Health District of Granada, Andalusian Health Service, Granada 18015, Spain. l.arribas@terra.es
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Arribas-Mir
authors.forename: Dolores
authors.initials: D
authors.lastname: Rueda-Lozano
authors.forename: María
authors.initials: M
authors.lastname: Agrela-Cardona
authors.forename: Tania
authors.initials: T
authors.lastname: Cedeño-Benavides
authors.forename: Carmen
authors.initials: C
authors.lastname: Olvera-Porcel
authors.forename: Aurora
authors.initials: A
authors.lastname: Bueno-Cavanillas
mesh_terms: D000293:Adolescent; D000328:Adult; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D003271:Contraceptive Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D017135:Desogestrel / Q000008:administration & dosage* / Q000009:adverse effects; D004343:Drug Implants; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008599:Menstruation Disturbances / Q000139:chemically induced; D008875:Middle Aged; D013030:Spain; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D004343:Drug Implants; C044815:etonogestrel; D017135:Desogestrel