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L’evoluzione della contraccezione di lunga durata con solo progestinico: l’impianto sottocutaneo con etonorgestrel (ENG)


ABSTRACT

{ITA} I preparati contraccettivi a base di solo progestinico possono offrire alcuni vantaggi rispetto a quelli contenenti anche estrogeni e rappresentano una valida alternativa per le pazienti che hanno controindicazioni all’uso dell’estro-progestinico. In particolare l’impianto contraccettivo contenente etonogestrel (ENG) attualmente in commercio, ha una lunga durata di azione, buona reversibilità ed efficacia, con meno dell’1% di gravidanze indesiderate durante il primo anno di utilizzo e si può considerare molto conveniente. Le controindicazioni all’ impianto sono rare sia per l’assenza della componente estrogenica che per l’assenza dell’effetto del primo passaggio epatico.

Obiettivo di questa review è quello di dare maggiori dettagli e caratteristiche sull’impianto sottocutaneo contenente ENG, sulle sue proprietà farmacologiche e procedure d’inserimento, nonché sulle possibili strategie per il trattamento dei sanguinamenti irregolari impianto-correlati, che rappresentano una delle principali motivazioni di sospensione del trattamento.

{ENG} Progestogen-only contraceptives may provide several advantages in comparison to those containing estrogen-progestagen combinations and represent a valid alternative for patients who have contraindications to the use of estroprogestin. In particular, the contraceptive implant containing ethonogestrel (ENG) currently in use has a long duration of action, great reversibility and effectiveness, with less than 1% of unwanted pregnancies during the first year of use and can be considered very convenient. Contraindications to the implant are rare both for the absence of the estrogenic component and for the absence of the effect of the first hepatic passage.

The aim of the present review is give more insights and characteristics of the subcutaneous implant containing ENG, its pharmacological properties and insertion procedure, as well as the possible strategies for the treatment of implant-related irregular bleeding, which represent one of the main reasons for treatment discontinuation.


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