Experience with Jadelle Contraceptive Implant in obese and overweight women in south-eastern Nigeria

Abstract

Background: As the worldwide obesity epidemic continues, the Obstetrician Gynaecologist must discuss contraception with obese women who want to postpone pregnancy. Obesity may affect the efficacy of hormonal contraceptives by altering how they are absorbed, distributed, metabolized or eliminated. There is a paucity of data about the suitability and efficacy of Jadelle and other hormonal contraceptives in overweight and obese women in our locale.

Objective: This study describes the discontinuation, complication and pregnancy rates of Jadelle contraceptive implant in overweight and obese women compared to women of normal BMI. Design: An observational study.

Setting: The family planning unit of a private hospital in Osisioma Ngwa Local Government Area, Abia State, Nigeria, under the Womens’ Health Project of Society for Family Health. Subject: One hundred and two women of high BMI (64 overweight and 38 obese women) and 153 women of normal BMI who accepted Jadelle contraceptive implant.

Results: There was no statistically significant difference in the continuation (p = 0.78) and discontinuation rates (p = 0.71) between the high and normal BMI groups. The reasons for discontinuation of Jadelle before the expiration period of 5 years were similar for all BMI groups and they included prolonged and irregular vaginal bleeding and desire for another pregnancy. Side effects were similar and minimal for all BMI groups and mainly prolonged or irregular vaginal bleeding. Pregnancy was confirmed on two women of normal weight and this occurred within the first 2 months of use. Apparently, the women were pregnant at the time of insertion.

Conclusion: Jadelle contraceptive implants are well tolerated and effective in obese and overweight women in South-Eastern Nigeria who desire effective pregnancy prevention for 5 years.