Many women interested in receiving Norplant implants—especially when the method was first introduced—were told that they would be less effective in women weighing over 154 pounds. This is no longer the case.
Initially, the capsules were made of a dense material that somewhat reduced their effectiveness. All implants manufactured now contain softer, less dense tubing that allows for greater flow of hormones out of the tubes and into the bloodstream.
Unfortunately, no American women were studied earlier than 6 weeks after giving birth, making it impossible for the Food and Drug Administration to recommend the use of Norplant implants for women right after delivery. This lack of support from the FDA makes it difficult for doctors to recommend immediate postpartum insertion, even though studies outside the U.S. have documented its safety.
The issue is probably moot, because the act of breastfeeding can provide pregnancy protection for at least 6 weeks postpartum. Women in many developing countries (and even a small number of American women) actually use breastfeeding as a means of contraception. The method, which requires breast milk to be the infant's only source of nutrition, is known as the lactational amenorrhea method, or “LAM.”
Thromboembolic disorders: Progestins are not known to cause the clots or blockages of blood vessels found in thromboembolic disease, but if you have an active case, your physician may suggest another method. If you develop any such disorder while using the implants, you should probably have them removed. If you had thromboembolic disease in the past, you are probably not a good candidate for Norplant implants.
Insertion site complications: With proper antiseptics, the insertion site seldom becomes infected. The skin can become irritated even several months after insertion, but this, too, is rare.
DEPOPROVERA PROS AND CONS
DepoProvera is becoming a popular option with women of all ages. To help you decide if you'd like to try the contraceptive injection, here's a quick list of advantages and disadvantages:
Advantages
Extremely effective
Safe for most women
Longlasting but easy to discontinue
No need to remember to use
No interruption of sex
No estrogenrelated side effects
Possible cessation of the menstrual cycle
Decreased menstrual cramps and pain
Decreased anemia
Possible reduction in risk of pelvic inflammatory disease and endometriosis
Possible reduction in risk of endometrial cancer
Disadvantages
Offers no protection against sexually transmitted diseases (STDs)
Can delay return to fertility up to 2 years
Lasts for 3 months with no option to discontinue during that time
May produce nuisance side effects, especially irregular bleeding and weight gain
Nuisance Side Effects
Norplant implants can cause some of the same nuisance side effects as the Pill, including acne, breast tenderness, depression, headaches, nausea and weight gain. Other side effects that have been noted include nervousness and dizziness, skin rash, breast discharge, changes in appetite, and hair loss or growth. But by far the most common side effect of the implants is irregular bleeding.
In the many studies of the system, 60 to 100 percent of users experienced some kind of menstrual change, especially in the first few months. These changes can include bleeding for a longer time than usual per cycle (27.6 percent), spotting between periods (17.1 percent), frequent bleeding onsets (7.0 percent), infrequent or light bleeding (5.2 percent), or no bleeding at all (9.4 percent).
It is important to note that even with these irregular patterns of increased bleeding, women using Norplant implants lose less blood than women with normal menstrual cycles. Studies show that Norplant implant users have higher hemoglobin levels than nonusers do. This could prove beneficial for women prone to anemia.
Here is a list showing the rate of side effects seen during two multinational studies:
