{
    "abstract": "This study aimed to describe the use of etonogestrel (ENG) implants for menstrual management (i.e., management of bleeding and symptoms associated with menstruation) in individuals with intellectual disabilities.\nThis study retrospectively analyzed a cohort of individuals with intellectual disabilities who began using ENG implants between 2003 and 2018, in Joinville, Brazil. We collected sociodemographic, clinical, and reproductive data from the medical records, along with information related to ENG implant use.\nIn total, 369 implants were placed in 130 individuals with intellectual disabilities. The median age at the first implant was 20 (interquartile range [IQR], 17-26) years, and 43.8% of the patients were adolescents. By December 2018, 90 patients had received two or more subsequent implants. The median duration of current ENG implant use was 19 (IQR, 12.8-22) months. More than 40% of the patients had comorbidities, with epilepsy being the most common. During the use of the current implant, 80% of the patients had a favorable bleeding profile (no bleeding or \u22641 bleeding episode per month), and 53.8% (70/130) had no bleeding within 3\u2009months before their last medical visit. Among patients experiencing dysmenorrhea and premenstrual syndrome (PMS), 79% (64/81) and 82% (54/66) reported complete improvement, respectively. The premature implant removal rate was 8.9% (33/369). Unfavorable bleeding was the main reason for premature implant removal (20 out 33 removals).\nENG implants might be a suitable option for individuals with intellectual disabilities who require management of menstrual bleeding and symptoms associated with menstruation. Most patients had a favorable bleeding profile and experienced significant improvements in dysmenorrhea and PMS, contributing to the high continuation rates of ENG implants.",
    "authors": [
        {
            "affiliation": "Department of Obstetrics and Gynecology, Ribeirao Preto Medical School, University of S\u00e3o Paulo, Ribeir\u00e3o Preto, SP, Brazil.\nDepartment of Social Medicine, Ribeirao Preto Medical School, University of S\u00e3o Paulo, Ribeir\u00e3o Preto, SP, Brazil.",
            "firstname": "Giordana Campo",
            "initials": "GC",
            "lastname": "Braga"
        },
        {
            "affiliation": "N\u00facleo de Assist\u00eancia Integral ao Paciente Especial, Joinvile, SC, Brazil.",
            "firstname": "Carla Josene",
            "initials": "CJ",
            "lastname": "Zarabia"
        },
        {
            "affiliation": "N\u00facleo de Assist\u00eancia Integral ao Paciente Especial, Joinvile, SC, Brazil.",
            "firstname": "Adriana Kelly Soares de S",
            "initials": "AKSS",
            "lastname": "da Trindade"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Ribeirao Preto Medical School, University of S\u00e3o Paulo, Ribeir\u00e3o Preto, SP, Brazil.",
            "firstname": "Carolina Sales",
            "initials": "CS",
            "lastname": "Vieira"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2024 International Federation of Gynecology and Obstetrics.",
    "doi": "10.1002/ijgo.15930",
    "journal": "International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics",
    "keywords": [
        "etonogestrel implant",
        "intellectual disability",
        "long\u2010acting reversible contraception",
        "menstrual management",
        "menstrual suppression",
        "premenstrual syndrome"
    ],
    "methods": null,
    "publication_date": "2024-10-01",
    "pubmed_id": "39350685",
    "results": "In total, 369 implants were placed in 130 individuals with intellectual disabilities. The median age at the first implant was 20 (interquartile range [IQR], 17-26) years, and 43.8% of the patients were adolescents. By December 2018, 90 patients had received two or more subsequent implants. The median duration of current ENG implant use was 19 (IQR, 12.8-22) months. More than 40% of the patients had comorbidities, with epilepsy being the most common. During the use of the current implant, 80% of the patients had a favorable bleeding profile (no bleeding or \u22641 bleeding episode per month), and 53.8% (70/130) had no bleeding within 3\u2009months before their last medical visit. Among patients experiencing dysmenorrhea and premenstrual syndrome (PMS), 79% (64/81) and 82% (54/66) reported complete improvement, respectively. The premature implant removal rate was 8.9% (33/369). Unfavorable bleeding was the main reason for premature implant removal (20 out 33 removals).",
    "title": "Menstrual management using the etonogestrel implant in individuals with intellectual disabilities in Joinville, Brazil.",
    "xml": "<Element 'PubmedArticle' at 0x788504ebca40>"
}