Patient satisfaction and side effects with levonorgestrel implant (Norplant) use in adolescents 18 years of age or younger.

OBJECTIVES

Levonorgestrel implants (Norplant) have recently been approved for use in the United States. Adolescents may be especially suited for this method of contraception because of its long duration of action and lack of dependence on patient compliance for efficacy. To date, however, its use in young patients has not been investigated. This study was undertaken to compare side effects and satisfaction with this new method during the first 6 months of use among adolescents and adults.

METHODS

Twenty-one adolescents 18 years of age or younger and 30 adults 19 years or older participated in this study. Information on side effects and satisfaction was obtained from clinic records and a structured interview conducted 6 months after insertion.

RESULTS

The most frequent reason adolescents gave for selecting Norplant was convenience. None of the adolescents were upset by the insertion process or by its appearance in the arm, although 10 (48%) reported that it was visible. The most frequent side effect reported by both adolescents (71%) and adults (53%) was abnormal menstrual bleeding. Weight gain was reported by 8 adolescents (38%), 3 of whom attributed it to an increase in their appetite. Other side effects commonly reported by adolescents included emotional disturbances (33%) and headaches (38%), whereas adults reported acne (27%) and mastalgia (37%). Only 1 adolescent (5%) and 1 adult (3%) reported experiencing no side effects. A similar percentage of adolescents (8%) compared with adults (6%) requested removal of the implant because of side effects during the 6-month period. Overall, satisfaction was expressed by 86% (18/21) of adolescents, all of whom stated that they preferred Norplant to their previous contraceptive method.

CONCLUSIONS

This investigation demonstrates that levonorgestrel implants are well tolerated by most young patients. Clinicians involved in the care of adolescents should consider Norplant as an appropriate option of birth control for this population.