The Acceptability of Implanon in Muslim-Majority Asian Countries: A Systematic Review
-
Nik Asyraf Nik Azis
,
Mohamed S. Zulfarina
,
Nurul ‘Izzah Ibrahim
,
Alia Syamim Zahari
,
Aisyah Sulaiman
,
Ng Xue Min
,
Azura Abdullah
,
Alina Ali
,
Norhalili Mohamad Tamiri
,
Isa Naina-Mohamed
Abstract
Background: We conducted a systematic review which aimed to assess acceptability of implanon used based on reported side effects, continuation rates and user satisfaction in Muslim-majority Asian countries.
Methods: We followed PRISMA guideline and searched SCOPUS and Medline databases for original articles that dealt with implanon, conducted in Muslim-majority Asian countries and had either continuation rates or side effects or satisfaction rate. The risk of bias of the selected studies was assessed using ROBINS-I V2 Risk of Bias tool.
Results: The literature search successfully identified 7 potentially relevant articles, whereby 5 of them met the inclusion criteria. 5 articles were retained in the final synthesis with 619 total participants. Implanon’s documented side effects such as menstrual irregularity and weight gain, is tolerable due to its high efficacy. Implanon has low discontinuation rates among users and has a high satisfaction rate.
Conclusion: Implanon is widely accepted in Muslim-majority Asian countries with a positive impact on family planning.
1. Cambridge Dictionary (2024); Definition of Contraception. Available from: https://dictionary.cambridge.org/dictionary/english/contraception
2. Cai Y, Feng W (2021). The Social and Sociological Consequences of China’s One-Child Policy. Annu Rev Soci, 47(1):587-606
3. Smith TW (1980). The use of law to encourage smaller families in Singapore. Fletcher Forum, 4(1):69–87.
4. D’Souza P, Bailey JV, Stephenson J, Oliver S (2022). Factors Influencing Contracep-tion Choice and Use Globally: a Synthe-sis of Systematic Reviews. Eur J Contra-cept Reprod Health Care, 27(5):364-372.
5. Conde-Agudelo A, Rosas-Bermúdez A, Ka-fury-Goeta AC (2006). Birth Spacing and Risk of Adverse Perinatal Outcomes. JAMA, 295(15):1809-23.
6. United Nations (2024). Sustainable Devel-opment Goal 3: Good Health and Well-being | United Nations in Malaysia, Singapore and Brunei Darussalam.
7. National Collaborating Centre for Wom-en’s and Children’s Health (UK) (2005). Long-acting Reversible Contraception: The Effective and Appropriate Use of Long-Acting Reversible Contraception. London: RCOG Press.
8. Graesslin O, Korver T (2008). The contra-ceptive efficacy of Implanon: a review of clinical trials and marketing experi-ence. Eur J Contracept Reprod Health Care, 13 Suppl 1:4–12.
9. Booranabunyat S, Taneepanichskul S (2004). Implanon use in Thai women above the age of 35 years. Contraception, 69(6):489–91.
10. Kiriwat O, Patanayindee A, Koetsawang S, Korver T, Coelingh Bennink HJT (1998). A 4-year pilot study on the efficacy and safety of Implanon®, a single-rod hormonal contraceptive implant, in healthy women in Thailand. Eur J Con-tracept Reprod Health Care, 3(2):85–91.
11. Zheng SR, Zheng HM, Qian SZ, Sang GW, Kaper RF (1999). A randomized multicenter study comparing the efficacy and bleeding pattern of a single-rod (Implanon) and a six-capsule (Norplant) hormonal contraceptive implant. Contraception, 60(1):1–8.
12. Funk S, Miller MM, Mishell DR, Archer DF, Poindexter A, Schmidt J, et al (2005). Safety and efficacy of Implanon, a sin-gle-rod implantable contraceptive con-taining etonogestrel. Contraception, 71(5):319–26.
13. Harvey C, Seib C, Lucke J (2009). Continua-tion rates and reasons for removal among Implanon users accessing two family planning clinics in Queensland, Australia. Contraception, 80(6):527–32.
14. Mastor A, Khaing SL (2011). Users’ perspectives on Implanon in Malaysia, a multicultural Asian country. Open Access Journal of Contraception, 2:79–84.
15. Bitzer J, Tschudin S, Alder J, the Swiss Im-planon Study Group (2004). Acceptabil-ity and side-effects of Implanon in Switzerland: a retrospective study by the Implanon Swiss Study Group. Eur J Con-tracept Reprod Health Care, 9(4):278–84.
16. Grim B, Washington D, Hsu (2011). Estimating the Global Muslim Population: Size and Distribution of the World’s Muslim Population. Interdisciplinary Journal of Research on Religion, 7:2-19.
17. Kettani H (2010). Muslim Population in Asia: 1950 – 2020. International Journal of Environmental Science and Development, 1:136–42.
18. Bhartiya A (2013). Menstruation, Religion and Society. International Journal of Social Science and Humanity, 3(6):523–7.
19. Salako T (2022). Islamic perspectives on birth control. Tai Solarin University of Education, Nigeria.
20. Muda @ Ismail FS (2018). Contraceptive Implant from the Eyes of Syariah. Journal of Fatwa Management and Research, 7(1):167–79.
21. Mufti of Federal Territories Malaysia (2016). Irsyad al-fatwa series 146 : the ruling of family planning for low-income families. Mufti of Federal Territories Office, Malaysia.
22. Sterne JAC, Hernán MA, McAleenan A, Reeves BC, Higgins JPT (2019). Chapter 25: Assessing risk of bias in a non-randomized study. Cochrane Handbook for Systematic Reviews of Interventions version 6.5. Cochrane, 2024.
23. Yildizbas B, Sahin HG, Kolusari A, Zeter-oglu S, Kamacı M (2007). Side effects and acceptability of Implanon: A pilot study conducted in eastern Turkey. Eur J Contracept Reprod Health Care, 12(3):248–52.
24. Gezginc K, Balci O, Karatayli R, Colakoglu MC (2007). Contraceptive efficacy and side effects of Implanon. Eur J Contra-cept Reprod Health Care, 12(4):362–5.
25. Moamar Al-Jefout, Nedal Nawaiseh, Tashman S, Rawan Ryalat, Wassem Tabaza (2015). Jordanian Women’s Ex-perience with Etonogestrel Subdermal Contraceptive Implant in Two Family Planning Clinics. Jordan Medical Journal, 49(1):27–35.
26. Wali R, Alghamdi AM, Ahmed ST, et al (2023). Satisfaction With the Use of Sub-dermal Contraceptive Implant in Wom-en Attending the Specialized Polyclinic Primary Health Care Center in Jeddah City: A Cross-Sectional Study. Cureus, 15(3):e35902.
27. Shams TM, Alhashemi HH, Fallatah AA, et al (2024). Outcomes of etonogestrel subdermal contraceptive implants. Saudi Med J, 45(3):261–6.
28. Beesham I, Smit J, Beksinska M, et al (2019). Reasons for requesting removal of the hormonal implant, Implanon NXT, at an urban reproductive health clinic in KwaZulu-Natal, South Africa. S Afr Med J, 109(10):750-55.
29. Mesha M, Alemayehu A, Daka D (2020). Prevalence and factors associated with early discontinuation rate of Implanon utilization among women who ever used Implanon in Kucha District Gamo Gofa Zone, Southern Ethiopia. BMC Womens Health, 20(1):239.
30. Rakhshani F, Mohammadi M (2004). Con-traception continuation rates and rea-sons for discontinuation in Zahedan, Is-lamic Republic of Iran. East Mediterr Health J, 10 (3):260-7
31. Shiely F, Saifuddin MS (2014). Contracep-tive choice and acceptability: the future for STI risk in Kelantan, Malaysia. Int J STD AIDS, 25(3):219–27.
32. Belsey EM, Machin D, d’Arcangues C (1986). The analysis of vaginal bleeding patterns induced by fertility regulating methods. World Health Organization Special Programme of Research, Devel-opment and Research Training in Hu-man Reproduction. Contraception, 34(3):253–60.
33. Lavie CJ, Milani RV, Ventura HO (2009). Obesity and Cardiovascular Disease: Risk Factor, Paradox, and Impact of Weight Loss. J Am Coll Cardiol, 53 (21):1925–32.
34. Greenway FL (2015). Physiological adapta-tions to weight loss and factors favour-ing weight regain. Int J Obes (Lond), 39(8):1188–96.
35. Glasier A (2002). Implantable contracep-tives for women: effectiveness, discon-tinuation rates, return of fertility, and outcome of pregnancies. Contraception, 65(1):29–37.
2. Cai Y, Feng W (2021). The Social and Sociological Consequences of China’s One-Child Policy. Annu Rev Soci, 47(1):587-606
3. Smith TW (1980). The use of law to encourage smaller families in Singapore. Fletcher Forum, 4(1):69–87.
4. D’Souza P, Bailey JV, Stephenson J, Oliver S (2022). Factors Influencing Contracep-tion Choice and Use Globally: a Synthe-sis of Systematic Reviews. Eur J Contra-cept Reprod Health Care, 27(5):364-372.
5. Conde-Agudelo A, Rosas-Bermúdez A, Ka-fury-Goeta AC (2006). Birth Spacing and Risk of Adverse Perinatal Outcomes. JAMA, 295(15):1809-23.
6. United Nations (2024). Sustainable Devel-opment Goal 3: Good Health and Well-being | United Nations in Malaysia, Singapore and Brunei Darussalam.
7. National Collaborating Centre for Wom-en’s and Children’s Health (UK) (2005). Long-acting Reversible Contraception: The Effective and Appropriate Use of Long-Acting Reversible Contraception. London: RCOG Press.
8. Graesslin O, Korver T (2008). The contra-ceptive efficacy of Implanon: a review of clinical trials and marketing experi-ence. Eur J Contracept Reprod Health Care, 13 Suppl 1:4–12.
9. Booranabunyat S, Taneepanichskul S (2004). Implanon use in Thai women above the age of 35 years. Contraception, 69(6):489–91.
10. Kiriwat O, Patanayindee A, Koetsawang S, Korver T, Coelingh Bennink HJT (1998). A 4-year pilot study on the efficacy and safety of Implanon®, a single-rod hormonal contraceptive implant, in healthy women in Thailand. Eur J Con-tracept Reprod Health Care, 3(2):85–91.
11. Zheng SR, Zheng HM, Qian SZ, Sang GW, Kaper RF (1999). A randomized multicenter study comparing the efficacy and bleeding pattern of a single-rod (Implanon) and a six-capsule (Norplant) hormonal contraceptive implant. Contraception, 60(1):1–8.
12. Funk S, Miller MM, Mishell DR, Archer DF, Poindexter A, Schmidt J, et al (2005). Safety and efficacy of Implanon, a sin-gle-rod implantable contraceptive con-taining etonogestrel. Contraception, 71(5):319–26.
13. Harvey C, Seib C, Lucke J (2009). Continua-tion rates and reasons for removal among Implanon users accessing two family planning clinics in Queensland, Australia. Contraception, 80(6):527–32.
14. Mastor A, Khaing SL (2011). Users’ perspectives on Implanon in Malaysia, a multicultural Asian country. Open Access Journal of Contraception, 2:79–84.
15. Bitzer J, Tschudin S, Alder J, the Swiss Im-planon Study Group (2004). Acceptabil-ity and side-effects of Implanon in Switzerland: a retrospective study by the Implanon Swiss Study Group. Eur J Con-tracept Reprod Health Care, 9(4):278–84.
16. Grim B, Washington D, Hsu (2011). Estimating the Global Muslim Population: Size and Distribution of the World’s Muslim Population. Interdisciplinary Journal of Research on Religion, 7:2-19.
17. Kettani H (2010). Muslim Population in Asia: 1950 – 2020. International Journal of Environmental Science and Development, 1:136–42.
18. Bhartiya A (2013). Menstruation, Religion and Society. International Journal of Social Science and Humanity, 3(6):523–7.
19. Salako T (2022). Islamic perspectives on birth control. Tai Solarin University of Education, Nigeria.
20. Muda @ Ismail FS (2018). Contraceptive Implant from the Eyes of Syariah. Journal of Fatwa Management and Research, 7(1):167–79.
21. Mufti of Federal Territories Malaysia (2016). Irsyad al-fatwa series 146 : the ruling of family planning for low-income families. Mufti of Federal Territories Office, Malaysia.
22. Sterne JAC, Hernán MA, McAleenan A, Reeves BC, Higgins JPT (2019). Chapter 25: Assessing risk of bias in a non-randomized study. Cochrane Handbook for Systematic Reviews of Interventions version 6.5. Cochrane, 2024.
23. Yildizbas B, Sahin HG, Kolusari A, Zeter-oglu S, Kamacı M (2007). Side effects and acceptability of Implanon: A pilot study conducted in eastern Turkey. Eur J Contracept Reprod Health Care, 12(3):248–52.
24. Gezginc K, Balci O, Karatayli R, Colakoglu MC (2007). Contraceptive efficacy and side effects of Implanon. Eur J Contra-cept Reprod Health Care, 12(4):362–5.
25. Moamar Al-Jefout, Nedal Nawaiseh, Tashman S, Rawan Ryalat, Wassem Tabaza (2015). Jordanian Women’s Ex-perience with Etonogestrel Subdermal Contraceptive Implant in Two Family Planning Clinics. Jordan Medical Journal, 49(1):27–35.
26. Wali R, Alghamdi AM, Ahmed ST, et al (2023). Satisfaction With the Use of Sub-dermal Contraceptive Implant in Wom-en Attending the Specialized Polyclinic Primary Health Care Center in Jeddah City: A Cross-Sectional Study. Cureus, 15(3):e35902.
27. Shams TM, Alhashemi HH, Fallatah AA, et al (2024). Outcomes of etonogestrel subdermal contraceptive implants. Saudi Med J, 45(3):261–6.
28. Beesham I, Smit J, Beksinska M, et al (2019). Reasons for requesting removal of the hormonal implant, Implanon NXT, at an urban reproductive health clinic in KwaZulu-Natal, South Africa. S Afr Med J, 109(10):750-55.
29. Mesha M, Alemayehu A, Daka D (2020). Prevalence and factors associated with early discontinuation rate of Implanon utilization among women who ever used Implanon in Kucha District Gamo Gofa Zone, Southern Ethiopia. BMC Womens Health, 20(1):239.
30. Rakhshani F, Mohammadi M (2004). Con-traception continuation rates and rea-sons for discontinuation in Zahedan, Is-lamic Republic of Iran. East Mediterr Health J, 10 (3):260-7
31. Shiely F, Saifuddin MS (2014). Contracep-tive choice and acceptability: the future for STI risk in Kelantan, Malaysia. Int J STD AIDS, 25(3):219–27.
32. Belsey EM, Machin D, d’Arcangues C (1986). The analysis of vaginal bleeding patterns induced by fertility regulating methods. World Health Organization Special Programme of Research, Devel-opment and Research Training in Hu-man Reproduction. Contraception, 34(3):253–60.
33. Lavie CJ, Milani RV, Ventura HO (2009). Obesity and Cardiovascular Disease: Risk Factor, Paradox, and Impact of Weight Loss. J Am Coll Cardiol, 53 (21):1925–32.
34. Greenway FL (2015). Physiological adapta-tions to weight loss and factors favour-ing weight regain. Int J Obes (Lond), 39(8):1188–96.
35. Glasier A (2002). Implantable contracep-tives for women: effectiveness, discon-tinuation rates, return of fertility, and outcome of pregnancies. Contraception, 65(1):29–37.
| Files | ||
| Issue | Vol 54 No 10 (2025) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v54i10.20123 | |
| Keywords | ||
| Implanon Contraception Acceptability Muslim Asia | ||
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How to Cite
1.
Nik Azis NA, Zulfarina MS, Ibrahim N ‘Izzah, Zahari AS, Sulaiman A, Xue Min N, Abdullah A, Ali A, Mohamad Tamiri N, Naina-Mohamed I. The Acceptability of Implanon in Muslim-Majority Asian Countries: A Systematic Review. Iran J Public Health. 2025;54(10):2101-2113.
