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Your Contraceptive Choices
From Planned Parenthood Federation of America
1996
Norplant®
Norplant is a reversible prescription method of birth control. Six soft capsules, each about the size of a cardboard matchstick, are inserted under the skin of the upper arm. Each one contains levonorgestrel—a synthetic hormone like the one produced by the body to regulate the menstrual cycle.
How and How Well Norplant Works
A small amount of the hormone is released constantly. The hormone keeps the ovaries from releasing eggs. It also thickens the cervical mucus. This keeps sperm from joining with an egg. Some researchers believe that Norplant also may work by preventing a fertilized egg from attaching to the lining of the uterus.
Norplant is the most effective reversible method of birth control—except for continuous abstinence. Of every 10,000 women who use Norplant, only nine will become pregnant in the first year of use. Left in place, it can protect against pregnancy for five years.
Norplant provides no protection against sexually transmitted infections.
Advantages
Norplant is very convenient, and it:
- gives continuous long-lasting birth control without sterilization
- does not need to be taken daily or put in place before vaginal intercourse
- can be used by women who cannot take estrogen
- can be used while breastfeeding (starting six weeks after delivery)
Who Can Use Norplant
Most women can use Norplant safely. You should not use Norplant if you:
- are pregnant
- have unexplained vaginal bleeding
- cannot put up with irregular bleeding
- are breastfeeding in the first six weeks after delivery
- ever had breast cancer
- have blood clots or inflammation of the veins
- have had growths of the liver
- have a history of a certain kind of high blood pressure—idiopathic intracranial hypertension
- have a certain kind of brain tumor—meningioma
- are sensitive to the ingredients in Norplant
You should be checked regularly by your clinician if you use Norplant and have:
- diabetes
- serious liver disease
- increasingly severe, constant headaches
- high cholesterol or blood pressure
- seizures that require medication
- conditions that may be aggravated by fluid retention
- heart disease
- serious depression
How Norplant Is Used
After taking your medical history and giving you a physical examination, the clinician will numb a small area of your arm with a painkiller and make one small cut. The six capsules will be inserted under the skin of the arm you use least. Insertion takes about 10 minutes. Protection against pregnancy begins within 24 hours.
Do not have Norplant inserted if there is a chance that you are pregnant. Be sure to tell your clinician if you think there is any chance that you are.
Your clinician will advise you to have a follow-up visit within the first three months after insertion. It is best to have follow-up visits once a year after that. Be sure to tell any health care provider you may see that you are using Norplant.
Norplant must be removed after five years because it stops working. If you wish, it can be removed anytime earlier. The clinician will numb the area with a painkiller and will make one small cut to remove all six of the implants. Removal takes from 15 to 20 minutes. Implants may be more difficult to locate in some women. Removal for them may require more than one visit and/or several incisions. New implants may be inserted at this time. Pregnancy can happen anytime after the implants are removed.
Possible Problems
Most women adjust to using Norplant with few or no problems. However, as with all medicines, there may be side effects for some women.
Side Effects
The most common side effect of Norplant is not serious. It is irregular bleeding. This may include:
- irregular intervals between periods
- longer menstrual flow
- irregular bleeding or spotting between periods
- no bleeding for months at a time
Bleeding usually becomes more regular after nine to 12 months. A small number of women experience irregular bleeding throughout the five years.
There are other side effects for some women. They may include:
- possible scarring at insertion and removal site
- headache
- change in appetite
- weight gain or loss
- sore breasts
- nausea
- nervousness
- dizziness
- changes in sex drive
- decreased vaginal lubrication
- acne
- gain or loss of hair on face and body
- discolored skin over the implants
- enlarged ovaries or tubes
- increased chance of ectopic pregnancy in the unlikely event that pregnancy occurs
It may be possible for women to predict the side effects they may experience while using Norplant before they have it inserted. They may do this by taking the progestin-only oral contraceptive, Ovrette®. Women who have no side effects while taking Ovrette may not have side effects while using Norplant.
Rare Serious Problems
Norplant works very much like the Pill, but it contains no estrogen. It is not yet known if problems that rarely occur with the Pill also may occur with Norplant. Smoking while using the Pill greatly increases the risks of blood clots, heart attack, and stroke in women who are over 35 years old. It is not yet known if this happens with Norplant. For now, women using Norplant are advised to stop smoking.
Some Norplant users have had ectopic (tubal) pregnancies. But ectopic pregnancy occurs less frequently for Norplant users than it does for women who use no method. However, in the rare case when Norplant fails, there is a greater chance that the pregnancy will be in the tubes. Ectopic pregnancies are life-threatening. They usually are removed with surgery.
Warning Signs
Tell your clinician immediately if:
- you have vaginal bleeding that lasts longer and is much heavier than your normal period
- your period is late after a long period of regular cycles
- you have severe abdominal pain—especially if it is only on one side
- you have severe headaches and/or blurred vision
- there is pain, pus, or bleeding at the implant site
- one of the implants seems to be coming out
- you have nerve pain while moving the arm or hand after the insertion site has healed.
How to Get Norplant and What It Costs
Visit a family planning clinic, your HMO, or private doctor.
Norplant costs between $500 and $750 for the medical examination, the implants, and the insertion. This amounts to a little more than $100 a year over a five-year period. Clinicians will charge an additional fee to remove Norplant—from $100 to $200. All costs are covered by Medicaid.
Norplant® is the registered trademark of the Population Council for levonorgestrel implants.
More Detail on Norplant
Continue - Depo-Provera
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