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SRH clinical consult
Implant and adolescents
  1. Elise D. Berlan1,2
  1. 1 Pediatrics/Adolescent Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
  2. 2 Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
  1. Correspondence to Dr Elise D. Berlan, Pediatrics/Adolescent Medicine, Nationwide Children's Hospital, Columbus OH 43205, Ohio, USA; Elise.Berlan{at}nationwidechildrens.org

https://doi.org/10.1136/bmjsrh-2020-200631

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    Key messages

    • Adolescents’ social networks are key sources of information about contraceptives. A friend’s personal experience, especially a negative one, can heavily influence an adolescent’s contraception decision-making.

    • Young people value receiving information about contraceptives and the endorsement of a method by a healthcare professional.

    • The incidence of difficult removals, migrations and device location failures for Nexplanon is exceedingly rare. Removal of non-palpable implants should be done by skilled specialists.

    Case

    Kristy, a 17-year-old girl, presents to clinic, having previously had a discussion of her contraceptive options with you. She is sexually active with her boyfriend and does not want to become pregnant. She feels that an implant would suit her and wishes to discuss it further as she has some concerns. Her friend had an implant, but when she requested a removal, she had to be referred to a specialist as the implant was impalpable. Her friend’s experience is putting Kristy off and she doesn’t really understand how it could have happened.

    Discussion

    Kristy’s interest in the etonogestrel contraceptive implant has been challenged by her friend’s negative experience. Close personal contacts are adolescents’ primary source of information about contraceptives.1 2 Secondhand experiences with negative side effects are prevalent and weighted more heavily in contraception choice than positive experiences.1 2 An adolescent considering the use of a device may be especially concerned about physical harm to the body.

    Fortunately, contraceptive counselling and the endorsement of a …

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    Footnotes

    • Editor's note The details of this case are fictitious. Any resemblance to actual persons, living or dead, or actual events is coincidental.

    • Twitter @EliseBerlanMD

    • Funding The author has not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests EDB is a consultant to Merck and Bayer and is a Nexplanon Clinical Trainer.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Commissioned; externally peer reviewed.