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Norplant: satisfaction and side-effects.

Norplant: Satisfaction and Side-Effects

The contraceptive Norplant was made available in the US by the FDA in December, 1990 after having been approved in 16 countries and used by nearly half a million women worldwide. Norplant consists of six matchstick-size silicone rubber capsules that are implanted in a minor surgical procedure under the skin of a woman's upper arm. For five years, the capsules release a hormone to prevent pregnancy, but they can be removed--and fertility restored--at any time.

Norplant does not contain estrogen and delivers the lowest dose of any hormone-based method. The progestin used (levonorgestrel) is a steroid, however, and does have various side effects, the most commonly reported being menstrual changes.

In interviews of 200 women using Norplant in clinical trials in San Francisco in 1988, 84% reported menstrual changes, including irregular bleeding (41%), prolonged bleeding (39%), spotting between periods (32%) and more frequent bleeding (23%). 33% experienced a change in weight, 25% had headaches, 15% reported mood changes, and 15% reported acne. In international studies, 40-50% of Norplant users have bleeding complaints in the first year.

Two-thirds of the women were current users at the time of the interview. 88% of them said they continued to use it because they were satisfied with it. Of those who had discontinued use, 58% said it was due to side effects.

In the US, Norplant costs about $275 to have inserted. 86% of the women said they had no or only slight discomfort during the insertion. 60% said the insertion was less painful than they had expected.

Satisfaction varied among ethnic groups, with Black women being most satisfied with it. The researchers concluded that for the large majority of women in this trial, Norplant was highly acceptable, but information should be given about the potential side effects and to dispel misconception about the pain associated with insertion and removal of the implants.

On the international level, satisfaction also varies among countries. After one year of use, 76 per 100 women in the Scandinavian countries were still using Norplant, while 99 per 100 Sri Lankan women were still using it. After 3 years 88 per 100 Indonesian women were still using the implant.

Analysis from trials indicated very low pregnancy rates (.2 per 100 women for the first year and 3.9 per 100 users for the entire five years. Higher rates (8.5) were reported among women weighing more than 150 pounds, who seemed to metabolize it faster.

--Sources for this article were studies quoted in Women's Global Network for Reproductive Rights Newsletter, No. 29, April-June, 1989, pp 13-15 and No. 34, Jan-March, 1991, pp 17-21.
COPYRIGHT 1991 Association of Labor Assistants & Childbirth Educators
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1991, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Title Annotation:contraceptive implants
Publication:Special Delivery
Article Type:Product/Service Evaluation
Date:Jun 22, 1991
Previous Article:Contraceptives for the 21st century.
Next Article:Comparing Norplant and Depo-Provera.

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