Abstract
OBJECTIVE: To study the effects on the quality of life (QoL), sexual function and metabolic aspects in women using a subcutaneous implant containing Etonogestrel (ENG-implant) over 10 years of observation period. STUDY DESIGN: This study was performed from January 2011 to September 2023. A database was set up to collect data from women. Counseling on the ENG-implant to be inserted at the termination of pregnancy, and on insert a new device every 3 years was adopted. The Short Form-36 (SF-36), the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS) questionnaires were used to investigate the QoL, sexual function and sexual distress, respectively, of women at baseline and at 6, 12, 24, 36, 72 and 108-month follow-ups. Blood samples were collected from women to measure metabolic parameters. RESULTS: 32 of 52 (61.5 %) enrolled women completed the study. In summary, after removing the first (at 36th month of use) and the second implant (at 72nd month of use), 44 (84.6 %) and 32 (61.5 %) women asked for the insertion of a new device, respectively. Somatic (p < 0.001) and mental (p = 0.04) categories of SF-36 improved from the 12-month follow-up to the 108-month follow-up (p < 0.001). FSFI scores also increased from 12-month follow-up to the 108-month follow-up (p < 0.001). The improvement of the total scores depended on the gradual increase in each FSFI item (p < 0.001).FSDS score became statistically significant starting from the 12-month follow-up to the 108-month follow-up (p < 0.001). Although lipid metabolism, fasting glucose, liver function and hemostatic parameters were slightly reduced, they remained within the range of the normal values. CONCLUSIONS: The long observation period of 10 years allowed us to state that the ENG-implant could have neutral effects on metabolic parameters, promote a better quality of life, and improve sexuality in the users. The main limitation of our study was the small number of women enrolled, mainly due to the cost of the implant. These results should be confirmed on a larger sample.