Abstract
The objective of this study was to evaluate the contraceptive efficacy and clinical
performance of a Nestorone subdermal implant (NES) in the postpartum period. NES (n
= 100) and Copper T intrauterine device (T-Cu; n = 100) acceptors initiated contraception
at 8 weeks postpartum and were followed at monthly intervals during the first year
and at 3-month intervals thereafter. Pregnancy rates, breastfeeding performance, infant
growth, bleeding pattern, and side effects were assessed. Blood and milk NES concentration
were measured.
No pregnancy occurred in 2195 and 2145 woman-months of NES implant and T-Cu use, respectively.
No effect of NES on lactation and infant growth and no serious adverse events were
observed. Lactational amenorrhea was significantly longer in NES users (353 ± 20 days)
than in T-Cu users (201 ± 11 days). More NES users (55.8%) experienced prolonged bleedings
than did T-Cu users (36.2%). Concentrations of NES in breast milk ranged between 54–135
pmol/liter. The Nestorone implant is a highly effective contraceptive, safe for breastfed
infants because the steroid is inactive by the oral route.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to ContraceptionAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Improving access to quality care in family planning. Medical eligibility criteria for contraceptive use. WHO/FRH/FPP, Geneva1996
- Statement on breast feeding, fertility, and post-partum contraception. Statement by the International Medical Advisory Panel, 1989: 1-5 (November)
- Pharmacokinetics and bioavailability of ST-1435 administered by different routes.Contraception. 1993; 48: 548-556
- The progestin ST-1435 rapid metabolism in man.Contraception. 1994; 50: 275-289
- Long-term contraception with a single implant of the progestin ST-1435.Fertil Steril. 1981; 36: 737-740
- Contraception with subcutaneous capsules containing ST-1435. Pituitary and ovarian function and plasma levels of ST-1435.Contraception. 1981; 23: 63-75
- Contraception with subdermal implants releasing the progestin ST-1435.Contraception. 1992; 45: 49-55
- Clinical trial with Nestorone™ subdermal contraceptive implant.Contraception. 1995; 51: 33-38
- Contraceptive action of a synthetic progestin, ST-1435 (academic dissertation). Steroid Research Laboratory, Department of Medical Chemistry, University of Helsinki, Helsinki, Finland1986
- Pituitary, and ovarian function during contraception with one s.c. implant releasing a progestin, ST-1435.Contraception. 1982; 25: 299-306
- Contraception-dependent mechanisms of ovulation inhibition by the progestin ST-1435.Fertil Steril. 1985; 44: 19-24
- Ovarian function during use of Nestorone® subdermal implants.Contraception. 2000; 61: 199-204
- Unaltered lipoprotein and carbohydrate metabolism during treatment with contraceptive subdermal implants containing ST-1435.Contraception. 1985; 31: 123-130
- Milk, and plasma concentrations of the progestin ST-1435 in women treated parenterally with ST-1435.Contraception. 1990; 43: 555-562
- Nelson W.E. Textbook of Pediatrics. 8th ed. WB Saunders Company, Philadelphia1964
- The PHREG procedure, preliminary documentation. SAS Institute Inc, Cary, NC1991
- Statistical methods for rates, and proportions. John Wiley & Sons, New York1981: 24-36
- A microcomputer software for analysis of menstrual diaries.Contraception. 1988; 38: 157-163
- Nonparametric statistical methods. John Wiley & Sons, New York1972: 115,125, 131
- SAS/STAT™ guide for personal computers. 6th ed. SAS Institute Inc, Cary, NC1987
- Progestogen-only contraceptives during lactation.Contraception. 1994; 50: 35-53
- Fertility regulation in nursing women. IX. Contraceptive performance, duration of lactation, infant growth, and bleeding patterns during use of progesterone vaginal rings, progestin-only pills, NorplantR implants, and Copper T 380-A intrauterine devices.Contraception. 1997; 56: 223-232
- Fertility regulation in nursing women. IV. Long-term influence of a low-dose combined oral contraceptive initiated at day 30 postpartum upon lactation and infant growth.Contraception. 1983; 27: 13-25
- Effects of hormonal contraceptives on breast milk composition and infant growth.Stud Fam Plann. 1988; 6: 361-369
- Contraceptives for lactating women.Contraception. 1997; 55: 225-232
- Exposure to contraceptive hormones through breast milk—are there long-term health and behavioral consequences?.Int J Gynaecol Obstet. 1987; 25: 47-55
- Use of a single implant of Elcometrine (ST-1435), a nonorally active progestin, as a long acting contraceptive for postpartum nursing women.Contraception. 1999; 59: 115-122
- The place of progesterone in human contraception.J Steroid Biochem. 1987; 27: 991-994
- Transfer of contraceptive steroids in milk of women using long-acting gestagens.Contraception. 1982; 25: 321-331
- Performance of the Copper T-380 A intrauterine device in breastfeeding women.Contraception. 1989; 39: 603-618
Article info
Identification
Copyright
© 2002 Elsevier Science Inc. Published by Elsevier Inc. All rights reserved.
