Discontinuation Patterns Among Women Using Jadelle Contraceptive Devices in a Tertiary Hospital in South-South Nigeria

Abstract

: Introduction : The Jadelle subdermal contraceptive implant is a widely used hormonal contraceptive consisting of two rods, each consisting of a Levonorgestrel-releasing core encased in thin-walled silicon-rubber tubing. Our study examined the prevalence and discontinuation patterns of Jadelle among women in a Southern Nigerian Hospital. Materials and Methods : A review of the discontinuation patterns among Jadelle contraceptive device users in the University of Uyo Teaching Hospital over 3 years was carried out. The Case files of all clients who used Jadelle implant over the period were retrieved and analyzed. Results : Out of 2,980 clients using different contraceptive methods during the study period, 231 clients (7.8%) used the Jadelle implant. Of the 198 (85.7%) case notes available, most (52%) of them were aged 30-34 years, had attained a tertiary level of education (50.4%), and were grand-multiparous (50%). Fifty-six (56.6%) percent of clients used Jadelle for birth spacing while 44.5% used it for limiting family sizes. The most common menstrual pattern at 24 months follow-up was Amenorrhea (50%). Sixty clients (30.3%) discontinued the method for reasons which include the desire for pregnancy (48.3%), side effects (25%), change of method (11.5%), and husbands` view (5%). Discontinuation was more among the younger clients less than 36 years (86.7%). Conclusion : The Jadelle contraceptive device is associated with a number of side effects, however, the major reason for discontinuation was the desire for pregnancy, followed by the complications arising from Jadelle use. There is a need for more detailed client and spousal counseling, especially on the side effects of Jadelle to reduce discontinuation due to them.