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Effects of the etonogestrel contraceptive implant (Implanon®) on bone metabolism during lactation: a prospective study
  1. Candan Iltemir Duvan1,
  2. Yuksel Onaran1,
  3. Esra Aktepe Keskin1,
  4. Ebru Yüce1,
  5. Burcu Yanık2,
  6. Hasan Kafali1,
  7. Nilgun Ozturk Turhan1
  1. 1MD Department of Obstetrics and Gynecology, Turgut Ozal University School of Medicine, Ankara, Turkey
  2. 2MD Department of Physical Therapy and Rehabilitation, Turgut Ozal University School of Medicine, Ankara, Turkey
  1. Correspondence to Mrs Ebru Yüce, Department of Obstetrics and Gynecology, Turgut Ozal University, Alparslan Turkes Bulvari, Emek, Ankara 06560, Turkey; dr.ebruk{at}gmail.com

Abstract

Aim To evaluate the effects of the etonogestrel contraceptive implant (Implanon®) on bone metabolism in lactating women using markers for bone formation and resorption.

Study design This single-centre, prospective cohort study was conducted in Turgut Ozal University Medical Faculty Obstetrics and Gynecology Department with healthy lactating women aged between 24 and 38 years to compare the effect on bone metabolism of 6 months’ use of either the implant or a non-hormonal contraceptive method. The study group (n=25) used an implant and the control group (n=25) used a non-hormonal contraceptive intrauterine device inserted 40 days’ postpartum. Bone metabolism differences at the time of insertion and after 6 months were assessed quantitatively by biochemical analysis of serum and urine samples.

Results At baseline, serum levels of bone metabolism parameters were similar for the two groups. In the implant group, serum alkaline phosphatase (ALP) levels decreased (p=0.004) and total protein levels increased (p=0.045) at 6 months. In the control group, serum levels of bone metabolism parameters did not change at 6 months compared to baseline. However, serum levels of phosphorus (p=0.013) and ALP (p=0.003) decreased at 6 months compared to baseline.

Conclusion Six months’ postpartum use of Implanon was found to have no deleterious impact on bone turnover in healthy lactating women.

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Footnotes

  • This study was presented at the International Federation of Fertility Societies (IFFS)/American Society for Reproductive Medicine (ASRM) joint meeting in Boston, MA, USA, 12–17 October 2013.

  • Twitter Follow Nilgün Öztürk Turhan at @turhan_nilgn

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Ethics committees of Turgut Ozal University.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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