Adnexal complications in women under treatment with progestogen implants

Symptoms and complications related to pelvic organs in women treated with subdermal progestogen implants are described. Of a total of 709 women, 110 presented low abdominal discomfort of significance. One-hundred-eighteen episodes of low abdominal discomfort were reported during 11,519 months of treatment. Surgical exploration of the pelvic cavity was made for diagnosis and/or treatment of this symptom in 27 cases. Ovarian cysts were found in 11 cases, hematosalpinx was found in 3 patients, and one of the latter was associated with an ovarian cyst. In two instances, the exploration was negative. Implants filled with megestrol acetate gave the highest incidence of tubal pregnancies and the absolute number of ectopic pregnancies was clearly greater than expected for the general population. The present findings are discussed in comparison with other clinical trials of continuous progestogen reported in the literature.