The Effects of Implanon in the Symptomatic Treatment of Endometriosis
Jirawat Ponpuckdee MD*, Surasak Taneepanichskul MD*
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University
Objective : To evaluate the efficacy of Implanon on treatment of symptomatic endometriosis
Design : An open clinical study without control group
Setting : Family Planning Clinic and out patient department, King Chulalongkorn Memorial Hospital,
Bangkok, Thailand.
Materials and Methods : A total number of 50 women with symptomatic endometriosis who were diagnosed and
confirmed by laparoscopy or whose symptoms recurred after surgical treatment were recruited in the study .
These subjects were implanted Implanon subcutaneously at medial aspect of non-dominant forearm. The
intensity of pain was assessed with Visual Analog Scale (VAS) before insertion and at 4th and 12th weeks after
the insertion. The adverse effects were recorded by the patients in 4th and 12th weeks of treatment. The women
evaluated their satisfaction on treatment at the end of study.
Results : 50 women recruited in the study and all completed follow-up. Improvements of pain severity and
menstrual symptoms were observed. The mean + SD Visual Analog Scale score of dysmenorrheal were 7.08 +
2.09 at baseline, 3.72 + 2.04 at 4th week, and 0.84 + 1.67 at 12th week of treatment. During the study period,
regular menstruation, amenorrhea, spotting, and breakthrough bleeding were reported by 21(42%), 14(28%),
13(26%), and 2(4%). At final satisfaction evaluation, 6(12%) women were very satisfied, 34 (68%) were
satisfied, and 10(20%) were uncertain. All of acceptors continued to retaining the implant after study.
Conclusion : Implanon, a sub-dermal progestin implant is an effective hormonal alternative for treatment of
symptomatic endometriosis. However women should be carefully counseled regarding menstrual changes. It
has the potential for providing long-term treatment of endometriosis. Nevertheless, the further study should be
conducted to compare with other of modality of treatment.
Keywords : Endometriosis, Implanon, Dysmenorrhea
