Norplant

Norplant is a highly effective method of birth control that prevents pregnancy by continually releasing small amounts of the synthetic hormone progestin into the bloodstream. Six flexible rubber tubes (each about the size of a match stick) are inserted under the skin of the midportion of your upper arm. The tubes contain a synthetic progestin called levonorgestrel, which is similar to progesterone (a hormone produced naturally by a woman's body).

Note: New prescriptions for Norplant are no longer available, but a similar system with two tubes (Implanon) has been approved by the U.S. Food and Drug Administration and may soon be available. The following information applies specifically to women who are still using Norplant.


How it works
The hormone prevents ovulation (the ripening and rupture of a mature egg from one of the ovaries) and keeps sperm outside the uterus by changing the cervical mucus. Norplant is effective 24 hours after insertion and can prevent pregnancy for up to five years. The contraceptive effect disappears a few hours after the implants are removed.

Effectiveness
Norplant is more than 99 percent effective in preventing pregnancy.

When Norplant may not be a good choice
Norplant is not recommended if you're pregnant or have:
unexplained vaginal bleeding
breast cancer
certain liver diseases
certain cardiovascular diseases
cerebrovascular disease, such as stroke
diabetes with complications

Insertion
Norplant can be inserted during an office visit. To make sure that you're not pregnant, Norplant is typically inserted during the first seven days after you begin your period or:
after a previous set of capsules has been removed
after childbirth if you don't plan to breastfeed
six weeks after childbirth if you're breastfeeding (Occasionally, Norplant is inserted sooner than six weeks, as determined by your doctor.)
any time if you're currently taking birth control pills or have an intrauterine device
immediately after an abortion
To insert the Norplant tubes, the doctor begins by cleaning your upper arm with an antiseptic. (The midportion of the upper arm is always used as the insertion site because the area is not prone to developing fatty tissue. Even if you gain weight while the tubes are in your arm, they will still be easy to find for removal.) Then, the area will be numbed. The doctor will make a small incision and insert the six tiny tubes. The procedure typically takes 10 to 30 minutes. You may notice some tenderness in your upper arm for a while, but Norplant insertion is generally painless. You'll need to wear a bandage over the insertion point for a few days and avoid lifting heavy objects. Finally, your doctor may suggest a follow-up visit within the next three months and then at least once a year.


Benefits
Norplant is highly effective in preventing pregnancy for long periods of time, which may decrease worry about unplanned pregnancy. It also requires no special action just before sexual activity.
It may also decrease:

menstrual blood flow or cramping
the risk of uterine and ovarian cancer
the risk of pelvic inflammatory disease (PID), an infection of the uterus, ovaries and fallopian tubes
the risk of ectopic pregnancy

Risks/disadvantages
A number of side effects are possible with Norplant, but the most common is bleeding irregularity. You may notice:
irregular intervals between menstrual cycles
longer or heavier periods
spotting or bleeding between menstrual cycles
no periods for a few months
Menstrual cycles often resume regularity within nine to 12 months. However, some women have irregular cycles as long as they use Norplant.

Other side effects of Norplant may include:

headaches
changes in appetite
weight gain or loss
breast tenderness or discharge
nausea
depression or mood changes
dizziness
acne
increased hair growth on the body or hair loss on the scalp
discolored skin in the implant area
ovarian cysts
If you use Norplant, you may face a slightly increased risk of stroke or certain types of blood clotting disorders.

In very rare cases, women have become pregnant while using Norplant. If this happens, the implants must be removed. If you do become pregnant while using Norplant, you face a greater risk of ectopic pregnancy (when the fertilized egg implants itself outside the uterus). Ectopic pregnancy can be a life-threatening condition that requires immediate medical attention.

Norplant does not offer protection from sexually transmitted diseases (STDs), including HIV (the virus that causes AIDS). It contact your doctor for testing and treatment.


When to see the doctor
While using Norplant, contact your doctor if you:
have heavy vaginal bleeding that's unlike your normal period
have a late menstrual cycle after your periods have been regular for a long time
have a severe headache, arm pain or lower abdominal pain
think you may be pregnant
notice any pus or bleeding at the implant site after insertion or removal
suspect that one of the implants is coming out or moving out of place
want to stop using the implants (A minor surgical procedure must be done to remove the implants.)