User:Alyssamarino99/Contraceptive implant

Implant
The contraceptive implant is hormone-based and highly effective, approved in more than 60 countries and used by millions of women around the world. The typical implant is a small flexible tube measuring about 40mm in length. It is most commonly inserted subdermally in the inner portion of the upper, non-dominant arm by a trained and certified health care provider. After insertion, it prevents pregnancy by releasing progestin which inhibits ovulation. The two most common versions are the single-rod etonogestrel implant and the two-rod levonorgestrel implant.

Brands include: Norplant, Jadelle (Norplant II), Implanon, Nexplanon, Sino-implant (II), Zarin, Femplant and Trust

Benefits
Benefits of the implant include fewer, lighter periods; improved symptoms of premenstrual syndrome; long-lasting, up to three years; smoker- and breastfeeding-safe; and the convenience of not needing to remember to use it every day.

Side Effects
In some cases, adverse effects do occur, the most common being irregular bleeding or amenorrhea. Although irregularity in bleeding can be troublesome for some women, this also allows for use in treatment of dysmenorrhea, menorrhagia, and endometriosis. Less common symptoms include change in appetite, depression, moodiness, hormonal imbalance, sore breasts, weight gain, dizziness, pregnancy symptoms, and lethargy. Although rare, there is also a risk of complications occuring during insertion or removal of the implant.

Use Postpartum
With regard to helping women space their pregnancies appropriately, there is some debate about the most effective time to insert contraceptive implants after pregnancy. However, there may be little or no difference between immediate and delayed insertion in terms of continued use of implants at six months or in terms of women's satisfaction. Progestin containing implants (specifically etonogestrel) are safe for immediate insertion in both postpartum indivudals and those post-abortion.

Intrauterine device
An intrauterine device (IUD) is a small contraceptive device, often 'T'-shaped, which is implanted into the uterus. They can be hormonal or non-hormonal and are long-acting and the most effective types of reversible birth control. As of 2011, IUDs are the most widely used form of reversible contraception worldwide. Among types of birth control they, along with birth control implants, result in the greatest satisfaction among users. IUDs also tend to be one of the most cost-effective methods of contraception for women. Cons of intrauterine devices, similarly to implants, is the need for a trained healthcare professional for both insertion and removal.

Hormonal IUD
Hormonal IUDs contain the hormone levonorgestrel which is a progestin. Most commonly, products are inserted for 5 years, allowing them to release a low dose of hormones over that time frame. The mechanism of action of both hormonal and non-hormonal IUDs is similar, plus the addtional benefit of progestin causing a thickening of the cervical mucus.

The levonorgestrel IUD is highly efficacious and has a failure rate of only 0.2% in the first year of use. An additional benefit of hormonal IUDs is decreased blood loss, where 20-30% of patients will experience amenorrhea. Within 1-3 months of removing the intrauterine device however, patients should experience a return to their normal menstrual cycle. The most common side effect of levonorgestrel containing IUDs is spotting during the first 3 months.

Use in patients immediately postpartum can be discussed but the greater potential for expulsion and perforation must be carefully considered.

Non-hormonal IUD
Non-hormonal IUDs, also known as copper IUD s, are a hormone-free option of contraception available and work by two main mechanisms of action. They are thought to slow the rate at which sperm reaches the fallopian tubes or decreases fertilization of the egg. An increase of copper ions, along with other cells and enzymes, is what affects functioning of the sperm and the prevention of pregnancy.

Although they do have a higher risk of pregnancy compared to hormonal IUDs, failure rates with the copper IUD are still only approximately 0.8%. They also provide protection from anywhere between 2.5 to 10 years depending on the brand and manufacturer. Potential adverse effects of copper IUDs include heavier menses and increased menstrual cramping.

Copper IUDs have the ability to be inserted anywhere from 10 minutes to 48 hours postpartum. The disadvantage of this immediate insertion is the associated higher risk of expulsion or uterine perforation, however, the benefits greatly outweigh any potential risk. They also are safe to use in lactation.

An additional benefit of copper IUDs is their use in emergency contraception. Not only are the able to be used as a form of emergency contraception but a Cochrane review noted that they are the most effective method of emergency contraception as well. When inserted within 7 days of unprotected intercourse, they are able to reduce the risk of pregnancy by 99% and provide the added benefit of ongoing contraception in the patient too.