The Norplant implant system is one of the most effective birth control methods in use today. During the first year after insertion, there is only one pregnancy per 500 users. The system becomes less effective towards the end of its useful life, so it is extremely important to have the capsules replaced at the 5 year mark.
DON'T USE NORPLANT IMPLANTS IF YOU
Suspect you are pregnant
Have abnormal, unexplained vaginal bleeding
Take antiseizure medication or the antibiotic rifampin
Have active thromboembolic disease (blood clots)
Know or suspect you have breast cancer
Have acute liver dysfunction
Although the Norplant system prevents release of an egg, it will sometimes allow a follicle to begin developing. Lacking the usual hormonal cues that cause all but a dominant follicle to disappear at the end of a cycle, the out-of-control newcomer will continue to grow until it resembles a large ovarian cyst. In time, such enlarged follicles usually disappear. However, there is a slight danger of twisting or rupture, which could require surgery
The Benefits and Risks
Scientists have noted few if any serious complications with Norplant implants, probably because they don't contain estrogen, and release their contents slowly, thereby avoiding hormonal surges. To be on the safe side, the manufacturer relays warnings based on experience with the Pill, which contains estrogen. (For risks and complications of OCs, see preceding section of this chapter.) Other possible complications include bleeding irregularities, follicular abnormalities, tubal pregnancies, harm to the infant during breastfeeding, and thromboembolic disorders. Insertion site infections can also prove troublesome.
Bleeding irregularities: Since many women have irregular periods while using Norplant implants, it's possible that more serious conditions marked by vaginal bleeding could be overlooked. These conditions include cervical and endometrial cancer.
If you're like many other women, your period may gradually stop while you're using this method, a condition known as “amenorrhea.” But if you use Norplant implants and you suddenly stop having periods after being regular, it could mean you're pregnant. If you have 6 weeks or more of amenorrhea following normal periods, take a pregnancy test.
Follicular abnormalities: In the normal reproductive cycle, many ovarian follicles compete to become the one dominant enough to produce an egg. Those follicles not quite making the grade degenerate in a process known as “atresia.” Although Norplant implants suppress the ovulatory system in about 50 percent of users, sometimes follicles do start growing. Researchers have noted that in Norplant users, follicular atresia is sometimes delayed, causing follicles to grow beyond their normal size. These growths can't easily be distinguished from ovarian cysts. Although the enlarged follicles disappear on their own most of the time, if they twist or rupture, surgery may be required.
Tubal pregnancies: Tubal, or ectopic, pregnancies do occur among women using Norplant implants, but less often than among women using no method of birth control. If you begin to feel abdominal pain, especially after your implants have been in place for a long time, seek medical care to rule out ectopic pregnancy.
Breastfeeding: Progestinonly methods like Norplant implants and DepoProvera have no impact on breast milk production; on the contrary, some studies show that milk production increases in the presence of progestins.
When studies were conducted on the Norplant system in the United States, some of the subjects were women who had the implants placed while they were breastfeeding. Six weeks after delivery, these women were given Norplant implants, and their breastfed children were then monitored for 3 years. Small amounts of the system's hormone could be found in the infants, but it did not affect their growth or health.
