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Purely gestagenic implants

 
, medical expert
Last reviewed: 08.07.2025
 
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The transdermal contraceptive system EVRA is a combined estrogen-progestogen contraceptive. EVRA is a thin beige patch with a skin contact area of 20 cm2 . Each patch contains 600 mcg of EE and 6 mg of norelgestromin (a biologically active metabolite of norgestimate). In terms of the dosages of hormones entering the blood, the EVRA system corresponds to micro-dosed oral contraceptives. 150 mcg of norelgestromin and 20 mcg of EE enter the systemic bloodstream per day.

The patch is applied to 1 of 4 possible areas (buttocks, breasts, excluding mammary glands, inner arm, lower abdomen). During 1 menstrual cycle, 3 patches are used, each of which is applied for 7 days. The patch must be replaced on the same day of the week. Then a 7-day break should be taken, during which a menstrual-like reaction occurs.

The mechanism of action of the EVRA system is due to the suppression of ovulation and an increase in the viscosity of cervical mucus. It has been established that EVRA suppresses ovulation as effectively as COCs.

Advantages and disadvantages of implantable contraceptives

Advantages

  • Convenience of use, since there is no need to take the drug daily. At the same time, it is necessary to re-stick the patch weekly.
  • Release of minimal doses of hormones.
  • No first pass effect through the liver and gastrointestinal tract.
  • Rapid restoration of fertility after discontinuation.
  • Can be used by women of different ages.
  • Possibility of independent use (without the participation of medical personnel).
  • Few side effects.

Contraceptives

  • Does not contain estrogen
  • High efficiency, IP < 0.05 during the first year of use
  • Fast effect (< 24 hours)
  • No connection with sexual intercourse
  • Does not affect breastfeeding
  • Long term validity (up to 5 years)
  • Immediate restoration of fertility after capsule removal
  • No daily monitoring of intake is required.

Non-contraceptive

  • May reduce menstrual-like bleeding
  • May reduce menstrual pain
  • May reduce the severity of anemia
  • Prevention of endometrial cancer
  • Reduce the risk of developing benign breast tumors
  • Provides some protection against pelvic inflammatory disease

Flaws

  • Causes changes in the nature of menstrual flow in almost all women (irregular spotting during the first year of using the method)
  • Surgery is required to insert and remove implants.
  • A trained health care professional is required to insert and remove the capsules.
  • Possibility of some weight gain or loss
  • The impossibility of interrupting the action of the drug after an injection if complications arise
  • They do not protect against STIs, including hepatitis and HIV infection.
  • A relatively expensive method of contraception

Rules of use. The insertion and removal of implants is carried out in the first 5 days of the menstrual cycle or on any other day if there is certainty that the woman is not pregnant.

The procedure is a short surgical intervention that is performed under local anesthesia by a specially trained medical specialist.

Symptoms of possible complications when using implantable contraceptives

  • A missed period after several months of regular cycles (may be a sign of pregnancy)
  • Pain in the lower abdomen (may be a sign of an ectopic pregnancy)
  • Heavy or prolonged (> 8 days) bleeding from the genital tract
  • Severe headaches or blurred vision
  • Infection or bleeding at the injection site
  • Rejection of capsules

If any of the above symptoms occur, an urgent consultation with a doctor is required!

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