Reasons for Discontinuation of Implanon (Long-Acting Contraceptive Method) among Young Women in Buffalo City Metropolitan Municipality, South Africa: A Cross-Sectional Study

Patricia Khungelwa Mrwebi, Daniel Ter Goon, Eyitayo Omolara Owolabi, Oladele V. Adeniyi, Eunice P. Seekoe, Anthony Idowu Ajayi


Early discontinuation of implanon, a long acting reversible contraceptive (LARC) among reproductive age women in South Africa is a serious public health concern. The aim of this study was to examine the reasons for discontinuation of implanon while still in need of contraception among its previous users. This descriptive cross-sectional study involved 189 consecutively selected participants in two large family planning clinics in Buffalo Metropolitan Municipality, East London, South Africa. The mean duration of use was 11.2±7.1 months. Side effects such as heavy bleeding, severe headache and painful arm were the main reasons for discontinuation of implanon. Few participants reported wrong positioning (3.2%) and desire for more pregnancies (4.3%) as reasons for discontinuation. Surprisingly, 5.3% participants got pregnant while on implanon, warranting discontinuation. The side effects of implanon are the reason for early discontinuation of implanon among women who still need contraception. Pre-insertion counselling should empower women towards making informed decision on discontinuation and transition to other options.


South African Department of Health. National Contraception and Fertility Planning Policy and Service Delivery Guides, Pretoria. 2012.

Tsui AO, Mcdonald-Mosley R, Burke AE. Family planning and the burden of unintended pregnancies. Epidemiologic Reviews. 2010; 32:152–174.

Liu L, Becker S, Tsui A, et al. Three methods of estimating births averted nationally by contraception. Popul Stud (Camb). 2008; 62(2):191–210.

Miller G. Contraception as development? New evidence from family planning in Colombia. The Economic Journal. 2009; 120(545):709-736.

Weldegerima B, Denekew A. Women's knowledge, preferences, and practices of modern contraceptive methods in Woreta, Ethiopia. Research in Social and Administrative pharmacy, 2008; 4(3):302-307.

Blumenthal PD, Voedisch A, Gemzell-Danielsson K. Strategies to prevent unintended pregnancy: increasing use of long-acting reversible contraception. Human Reproductive Update, 2011; 17(1), 121-137.

Lince-deroche N, Harries J, Mullick S. Achieving universal access to sexual and reproductive health services: the potential and pitfalls for contraceptive services in South Africa. South African Health Review, 2016; 9:208.

UNFPA (2012). South Africa’s family planning is above average. Available from;

Health 24. Woman goes through hell with Implanon birth control implant. 2016. Available from:

Adams B. Subdermal implants : a recent addition to the choice of South African contraceptives. Professional Nurses Today, 2015; 19(2):32–34.

Patel M. Contraception: everyone’s responsibility. S Afr Med J. 2014; 104(9):644.

Goldstuck ND. Family planning in South Africa: Missing essentials and desirables. South African Medical Journal, 105(11):904-905.

Croxato BB, Makarainene L. The pharmacodynamics amd efficacy of implanon. An overview of the data. Contraception, 1998; 58(6 Suppl):91S-97S.

Ojule JD, Oranu EO, Enyindah CE. Experience with Implanon in Southern Nigeria. Journal of Medicine and Medical Sciences, 2012; 3(11):710-714.

Winner B, Peipert JF, Zhao Q et al. Effectiveness of long-acting reversible contraception. New England Journal of Medicine, 366(21): 1998-2007.

World Health Organization (WHO). Medical eligibility criteria for contraceptive use. A WHO family planning cornerstone. 4th edition. Geneva: WHO. 2010.

The National Institute for Health and Care Excellence. Long-acting reversible contraception: the effective and appropriate use of long acting reversible contraception. London: RCOG Press, 2005.

Kluge J, Steyn P. Contraceptives: A guide to product selection. South African Family Practice, 2010; 52(6), 499-504.

Pushpa B, Sangita N, Shiyani A, Chitra T. Implanon: Subdermal Single Rod Contraceptive Implant. The Journal of Obstetrics and Gynaecology of India. 2011; 61(4): 422-425.

Burusie A. Reasons for Premature Removal of Implanon among Users in Arsi Zone, Ohamia Region, Ethiopia. Reproductive System and Sexual Disorders, 2015: 4(1):1–6.

Ezegwui HU, Ikeako LC, Ishiekwene CI, Oguanua TC. The discontinuation rate and reasons for discontinuation of implanon at the family planning clinic of University of Nigeria Teaching Hospital (UNTH) Enugu, Nigeria. Nigerian Journal of Medicine. 2011; 20(4):448-450.

Mastor A, Si LK, Siti OZ. Users’ perspectives on implanon in Malaysia,a multicultural Asian country. Open Access Journal of Contraception, 2011; 2:79-84.

Green A. The five best contraceptives backed by science. . Evidence for Contraceptive option and HIV outcomes. 2017. Available from:

Harvey C, Seib C, Lucke J. Continuation rates and reasons for removal among Implanon users accessing family planning clinics in Queensland Australia. Contraception, 2009; 34(8), 39-56.

Komane. Review of breakthrough contraceptive, implanon. SABC. 2015:1. Available from:

Birhane K, Hagos S, Fantahun M. Early discontinuation of implanon and its associated factors among women who ever used implanon in Ofla District, Tigray, Nothern ethiopia. International Journal of Pharma Sciences and Research, 2015; 6(3): 544–551.

Zerihun H, Biru A, Worku A. Implanon removal experiences of women in Butajira, Ethiopian Journal of Health Development, 2015; 29(3):176–182.

Harper CC, Blum M, De Bocanegra HT et al. Challenges in translating evidence to practice: the provision of intrauterine contraception. Obstetrics & Gynecology, 2008; 111(6):1359-1369.

Rocca CH, Harper CC. Do racial and ethnic differences in contraceptive attitudes and knowledge explain disparities in method use? Perspectives on Sexual and Reproductive Health, 2012; 44(3):150-158.

Lakha F, Glasier AF. Continuation rates of implanon in the UK: Data from an observational study in Clinical settings. Contraceotion, 2006; 74:287-289.

Pam VC, Mutihir JT, Karshima JA, Kanhansan ML, Musa J, Daru PH. Factors associated with use and discontinuation of implanon contraceptive in Jos, Nigeria. Tropical Journal of Obstetrics and Gynaecology. 2014; 31: 45-56.

Shelton JD. Reduced Effectiveness of Contraceptive Implants for Women Taking the Antiretroviral Efavirenz (EFV): Still Good enough and for how long? Global Health: Science and Practice, 2015; 3(4): 528–531.


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