Archives of Gynecology and Obstetrics

, Volume 292, Issue 6, pp 1387–1391 | Cite as

Body composition and bone mineral density in users of the etonogestrel-releasing contraceptive implant

  • Waleska ModestoEmail author
  • Natália Dal´Ava
  • Ilza Monteiro
  • Luis Bahamondes
Gynecologic Endocrinology and Reproductive Medicine



There is scarce information about bone mineral density (BMD) and body composition (BC) among users of the etonogestrel (ENG)-releasing implant.


To evaluate BC and BMD in ENG-releasing implant users as compared to copper intrauterine device (Cu-IUD)-users.


A prospective study was conducted on 75 users of both contraceptive methods. BMD was evaluated at femoral neck (FN) and lumbar spine (LS) (L1–L4) and BC at baseline and at 12 months after insertion.


The mean (±SD) age was 30.4 ± 6.8 and 29.8 ± 8.4 years and body mass index (kg/m2) was 24.9 ± 4.1 and 24.6 ± 3.5 in ENG-releasing implant- and Cu-IUD-users, respectively. ENG-releasing implant users did not show significant differences on BMD at the LS and FN at 12 months of use. Furthermore, ENG-implant users had an increase in body weight at 12 months (p < 0.001) and an increase of 2 % in the percentage of body fat, when compared with Cu-IUD users. There was a significant increase in lean mass in ENG-implant users at 12 months (p = 0.020).


No significant changes of BMD were seen after the first year of use among the ENG-releasing implant-users, albeit an increase of weight and fat mass was seen when compared to Cu-IUD users.


Etonogestrel-releasing implant Bone mineral density Body composition 



W.M. received grants from the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), Grants# 2011/01554-4 and this study received financial support from the FAPESP Grants# 2012/12432-0.

Conflict of interest

The authors declare no conflict of interest.


  1. 1.
    Peterson HB, Curtis KM (2005) Long-acting methods of contraception. N Engl J Med 353(20):2169–2175CrossRefPubMedGoogle Scholar
  2. 2.
    Grimes DA (2009) Forgettable contraception. Contraception 80(6):497–499. doi: 10.1016/j.contraception.2009.06.005 CrossRefPubMedGoogle Scholar
  3. 3.
    Winner B, Peipert JF, Zhao Q et al (2012) Effectiveness of long-acting reversible contraception. N Engl J Med 366(21):1998–2007. doi: 10.1056/NEJMoa1110855 CrossRefPubMedGoogle Scholar
  4. 4.
    Bahamondes L, Bottura BF, Bahamondes MV et al (2014) Estimated disability-adjusted life years averted by long-term provision of long acting contraceptive methods in a Brazilian clinic. Hum Reprod 29(10):2163–2170. doi: 10.1093/humrep/deu191 CrossRefPubMedGoogle Scholar
  5. 5.
    Cundy T, Cornish J, Roberts H, Elder H, Reid IR (1998) Spinal bone density in women using depot medroxyprogesterone contraception. Obstet Gynecol 92(4 pt 1):569–573CrossRefPubMedGoogle Scholar
  6. 6.
    Scholes D, La Croix AZ, Ichikawa LE, Barlow WE, Ott SM (2004) The association between depot medroxyprogesterone acetate contraception and bone mineral density in adolescent women. Contraception 69(2):99–104CrossRefPubMedGoogle Scholar
  7. 7.
    World Health Organization (2005) WHO statement on hormonal contraception and bone health. Wkly Epidemiol Rec 80(35):302–304Google Scholar
  8. 8.
    Pongsatha S, Ekmahachai M, Suntornlimsiri N, Morakote N, Chaovisitsaree S (2010) Bone mineral density in women using the subdermal contraceptive implant Implanon for at least 2 years. Int J Gynaecol Obstet 109(3):223–225. doi: 10.1016/j.ijgo.2010.01.018 CrossRefPubMedGoogle Scholar
  9. 9.
    Freeman S, Shulman LP (2010) Considerations for the use of progestin-only contraceptives. J Am Acad Nurse Pract 22(2):81–91. doi: 10.1111/j.1745-7599.2009.00473.x CrossRefPubMedGoogle Scholar
  10. 10.
    Bahamondes L, Monteiro-Dantas C, Espejo-Arce X, Dos Santos Fernandes AM, Lui-Filho JF, Perrotti M, Petta CA (2006) A prospective study of the forearm bone density of users of etonogestrel- and levonorgestrel-releasing contraceptive implants. Hum Reprod 21(2):466–470CrossRefPubMedGoogle Scholar
  11. 11.
    Monteiro-Dantas C, Espejo-Arce X, Lui-Filho JF, Fernandes AM, Monteiro I, Bahamondes L (2007) A three-year longitudinal evaluation of the forearm bone density of users of etonogestrel- and levonorgestrel-releasing contraceptive implants. Reprod Health 4:11PubMedCentralCrossRefPubMedGoogle Scholar
  12. 12.
    De Laet C, Kanis JA, Oden A, Johanson H, Johnell O, Delmas P, Eisman JA, Kroger H, Fujiwara S, Garnero P, McCloskey EV, Mellstrom D, Melton LJ 3rd, Meunier PJ, Pols HA, Reeve J, Silman A, Tenenhouse A (2005) Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 16(11):1330–1338CrossRefPubMedGoogle Scholar
  13. 13.
    Beerthuizen R, van Beek A, Massai R, Mäkäräinen L, Hout J, Bennink HC (2000) Bone mineral density during long-term use of the progestagen contraceptive implant Implanon compared to a non-hormonal method of contraception. Hum Reprod 15(1):118–122CrossRefPubMedGoogle Scholar
  14. 14.
    Smith A, Reuter S (2002) An assessment of the use of Implanon in three community services. J Fam Plann Reprod Health Care 28(4):193–196CrossRefPubMedGoogle Scholar
  15. 15.
    Agrawal A, Robinson C (2005) An assessment of the first 3 years’ use of Implanon in Luton. J Fam Plann Reprod Health Care 31(4):310–312CrossRefPubMedGoogle Scholar
  16. 16.
    Lakha F, Glasier AF (2006) Continuation rates of Implanon in the UK: data from an observational study in a clinical setting. Contraception 74(4):287–289CrossRefPubMedGoogle Scholar
  17. 17.
    Wong RC, Bell RJ, Thunuguntla K, McNamee K, Vollenhoven B (2009) Implanon users are less likely to be satisfied with their contraception after 6 months than IUD users. Contraception 80(5):452–456. doi: 10.1016/j.contraception.2009.03.021 CrossRefPubMedGoogle Scholar
  18. 18.
    Modesto W, Bahamondes MV, Bahamondes L (2014) A randomized clinical trial of the effect of intensive versus non-intensive counselling on discontinuation rates due to bleeding disturbances of three long-acting reversible contraceptives. Hum Reprod 29(7):1393–1399CrossRefPubMedGoogle Scholar
  19. 19.
    Hohmann H, Creinin MD (2007) The contraceptive implant. Clin Obstet Gynecol 50(4):907–917CrossRefPubMedGoogle Scholar
  20. 20.
    Vickery Z, Madden T, Zhao Q, Secura GM, Allsworth JE, Peipert JF (2013) Weight change at 12 months in users of three progestin-only contraceptive methods. Contraception 88(4):503–508. doi: 10.1016/j.contraception.2013.03.004 PubMedCentralCrossRefPubMedGoogle Scholar
  21. 21.
    Mansour D, Bahamondes L, Critchley H, Darney P, Fraser IS (2011) The management of unacceptable bleeding patterns in etonogestrel-releasing contraceptive implant users. Contraception 83(3):202–210. doi: 10.1016/j.contraception.2010.08.001 CrossRefPubMedGoogle Scholar
  22. 22.
    Nault AM, Peipert JF, Zhao Q, Madden T, Secura GM (2013) Validity of perceived weight gain in women using long-acting reversible contraception and depot medroxyprogesterone acetate. Am J Obstet Gynecol 208(1):48.e1–48.e8CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Waleska Modesto
    • 1
    Email author
  • Natália Dal´Ava
    • 1
  • Ilza Monteiro
    • 1
  • Luis Bahamondes
    • 1
  1. 1.Human Reproduction Unit, Department of Obstetrics and Gynaecology, School of Medical Sciences and the National Institute of Hormones and Women’s HealthUniversity of Campinas (UNICAMP)CampinasBrazil

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