The effects of etonorgestrel implant (ImplanonR) on the lipid profile of Nigerian women
Background: Provision of contraceptive methods with minimal side effects will enhance uptake of contraception particularly in Nigeria where contraceptive prevalence rate remains low. The safety profile of ImplanonR, a long‑acting hormonal subdermal contraceptive containing etonogestrel, has not been adequately evaluated among Nigerian women.
Objective: To assess the effects of etonogestrel subdermal implant (ImplanonR) on lipid profile among Nigerian women.
Materials and Methods: The study was a longitudinal follow‑up of 54 consenting women selected over a 6‑month period at the Family Planning Clinic of the University College Hospital, Ibadan. After ImplanonR insertion, each woman was followed‑up monthly for a period of 12 months. Fasting venous blood samples were collected for quantification of serum lipids prior to insertion of the implant, then at 1st, 3rd, 6th, 9th, and 12th months of follow‑up.
Results: The mean age of the women was 34.4 ± 5.6 with a range of 22–47 years. The modal number of children was 2 ranging from 1 to 6. Total cholesterol (TC) levels showed a general tendency toward a rise. The rise was, however, only significant in the 3rd and 12th months of use. Serum triglycerides showed a tendency toward reduced levels, which were only significant at the 6th and 9th months of use. High‑density lipoprotein (HDL) levels were consistently and significantly elevated above baseline levels. Beyond the 3rd month, low‑density lipoprotein (LDL) levels were lower but not significantly compared with baseline levels. HDL/TC and HDL/LDL ratios were consistently and significantly elevated in comparison with baseline values.
Conclusion: Etonogestrel implant seems to cause significant effects on the lipid profile of Nigerian women. The increases were mainly in the HDL fraction, which suggests that the atherogenic and cardiovascular disease risks are reduced. We recommend larger studies to confirm our findings.
Keywords: Implanon; laevonorgestrel; subdermal implant
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