|
MEC for Patch and Ring Same as for Combined Pills; Implanon Implant MEC Same as for Norplant
The Expert Working Group incorporated three new contraceptive methods into the MEC—the combined hormonal contraceptive patch, the combined hormone-releasing vaginal ring, and the etonogestrel-releasing implant, Implanon. The hormone levels and patterns typical of the patch and the ring are similar to those for COCs, as are the type and frequency of side effects reported in comparative studies. Therefore, the meeting concluded, MEC classifications applying to COCs can be assumed to apply to the patch and ring as well. There is no direct evidence concerning use of either method among women with health conditions. The meeting also assumed that the MEC classifications for the 5-year levonorgestrel implant Norplant can also apply to the 3-year etonogestrel implant Implanon.
The Expert Working Group reclassified implants and also progestin-only injectables and the levonorgestrel-releasing IUD as far as obesity is concerned. All were changed to category 1 (use in any circumstance) from category 2 (generally use). Research involving the progestin-only injectable Depo-Provera (DMPA) leaves unclear whether obese women have more health problems, including additional weight gain or more bleeding changes, than DMPA users of lower weight (4, 19, 21).
Since the October 2003 meeting new evidence has become available showing that the effectiveness of Norplant implants decreases after the fourth year of use for women weighing over 70 kg.
|
