Implanon

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stop sterilization abuse

What is Implanon?
Implanon is a provider-controlled long-acting hormonal contraceptive implant that prevents pregnancy for a period of three years. Implanon is inserted under the skin of a woman’s upper arm. It prevents pregnancy by gradually dispensing etonogestrel, a progestogen hormone that inhibits ovulation and thickens the cervical mucus, thereby decreasing the mobility of sperm.

Implanon & Population Control
The women’s health movement has raised serious criticism regarding hormonal implants because they are long-acting and the woman has no control over them. Use of implants can be highly problematic in an environment where women are targets of population control programs. Furthermore, administration of implants is questionable when access to healthcare is limited and the public health care system is weak, because women may not get medical check-ups or may not be able to have the implant removed on demand, in case they experience negative side effects or desire a pregnancy.

Norplant, the first contraceptive implant, was introduced in 1983. Women’s health advocates have opposed Norplant because it has been used coercively on poor women and women of color both in so-called Third World countries and in the U.S. Norplant lends itself to abuse in eugenic and population control programs. Some specific examples of abuse include: women being denied removal on demand or discouraged from early removal, the insertion of Norplant free of charge but charging the full cost for early removal, and the stipulation that women on social welfare accept Norplant.

Health Concerns
Along with these ethical concerns, serious health problems have been associated with use of Norplant including blindness, depression and ectopic pregnancy. It was discovered that during clinical trials with Norplant, little emphasis was placed on recording the actual incidences of side-effects, and follow-up was inadequate. As women’s health advocates, we want to avoid this abuse of contraceptives and ensure that all side-effects experienced by women are taken seriously and studied thoroughly before the drug reaches the market. Since Implanon is a contraceptive analogous to Norplant®; we fear that similar problems may surface.

Implanon has the side-effects of progestogen-only contraceptives, such as the following:
  • Virtually all women will experience a change in bleeding pattern; this could include prolonged bleeding, frequent bleeding, infrequent bleeding or amenorrhea. Some women may even experience a range of these bleeding patterns while using Implanon.

  • Weight gain (20% of women experienced a weight increase of 10% or more)

  • Headaches, nausea, breast pain and mood swings

  • Acne (14% of women); 10% of pre-existing acne worsened

  • Beneficial side-effects: some women experienced an improvement in pre-existing acne (59%) or dysmenorrhea (88%) after the insertion of Implanon.

Assessment
Although there are some advantages of Implanon over Norplant, such as easier insertion and removal and a shorter duration of effects, they are similar in many respects. This leaves us with many questions: Will Implanon also become a tool for population control?; Will serious health concerns arise when Implanon is widely used in diverse populations?; Will Implanon be useful for women?; and How will it affect women whose health and nutritional status is compromised?

After reviewing the clinical data available on Implanon, we are not satisfied with the low number of trial participants and the way certain aspects were monitored. For example, return of fertility was measured by the return of ovulation within a period of three months following the removal of Implanon. We think this does not sufficiently confirm a woman’s ability to become pregnant or give birth to a healthy baby.

For more information, please e-mail: office@wgnrr.nl or write to WOMEN’S GLOBAL NETWORK FOR REPRODUCTIVE RIGHTS (WGNRR), VROLIKSTRAAT 453-D, 1092 TJ AMSTERDAM, THE NETHERLANDS