Reasons for early discontinuation of the contraceptive implant in adolescents: A qualitative study
Awarded 2013
Small Research Grants
Britt Lunde, MD, MPH
Icahn School of Medicine at Mount Sinai

Objectives: The objectives of this study were to develop a deeper understanding of the reasons for and experiences with early discontinuation of the contraceptive implant in an adolescent population, and to identify areas of need for improvement in counseling for implant placement and removal. Methods: This is a qualitative study, consisting of semi-structured interviews of adolescent patients aged 13 to 24 presenting for removal of the contraceptive implant within the first 6 months after placement. The interview guide consisted of questions that explore decision-making regarding placement and removal of the contraceptive implant, recollection of counseling, differences in anticipated and experienced side effects, and recommendations for counseling. Interview transcripts were analyzed and coded to identify themes. Results: 16 interviews were performed. The participants experienced significant side effects, which lead to frustration and disappointment over the decision to have the implant removed. Few adolescents felt comfortable discussing problems with the implant with their health care provider, or knew when to present for follow up care, instead relying on the internet to decide what side effects could be due to the implant and when to get the implant removed. After removal, many participants did not start a new form of contraception. Conclusions: The adolescents who chose to stop using the contraceptive implant highly desired to avoid pregnancy for the long term, and were unhappy that this method did not work for them. Need for continued support during experience of side effects and decision making for removal was identified.