Birth Control Pill

The second type of long term birth control is a Norplant system (levonorgestrel implants). A Norplant system consists of small Silastic capsules that are placed under a woman’s arm. The implants are usually only are visible if a woman is very thin or muscular. The capsules release low doses of a progestin that prevent conception by: suppressing ovulation, creating more viscous cervical mucus, suppressing endometrium growth, and may also prevent conception by limiting progesterone secretion during the luteal phase of menstruation. Depending on the type of Norplant system implanted, the system can function from three to five years. For the first three years the system is 99.7% effective at preventing pregnancy, while the rate drops to 99.3% by the fifth year of use. Currently Norplant systems cost about $365 per system plus a doctor’s fee.
The most common side effect of Norplant is irregular menstrual bleeding. One woman in eleven will discontinue Norplant during the first year because of this effect. On average, these women have the implants removed after about seven months of use. Irregular menstrual bleeding caused by Norplant tends to lessen within nine to twelve months of use. Weight gain, headaches, and nervousness are also reported side effects. Because Norplant is a progestin, it has most all the side effects related to their use, i.e., it has the same effects associated with Depo-Provera.

Since Norplant systems are implants that release small doses of progestin, unlike Depo-Provera, the implants must be removed when the doses expire. The Norplant removal procedure is more difficult than the implants’ insertion. Removing Norplant systems generally takes about thirty minutes. Of the women having the Norplant implants removed, 19% of the procedures will take over an hour and 24% of the women polled reported the pain as ‘significant’. Pain usually occurs when the insertion border is too deep. Improvements in the implantation and removal techniques have reduced this problem. For example, the Emory Method of Norplant removal has diminished the removal time to under ten minutes. Likewise if Norplant was developed as a one or two rod system, instead of six sticks, the removal procedure would be easier and less painful.