A cohort study of Norplant implant: side-effects and acceptance.

OBJECTIVES

Menstrual irregularity is the main cause of termination of Norplant use; a study of its safety and level of acceptance is needed.

STUDY

METHODS

A cohort study using medical records of Dr Kariadi Hospital, Semarang, Indonesia and interviews between Norplant and IUD users who had in 1993 been followed-up for 5 years. Expulsion rate, removal rate, level of acceptance and satisfaction were examined.

RESULTS

From 170 Norplant and 168 IUD acceptors, the net cumulative pregnancy rates by month 36 of the Norplant and the IUD groups were 0.0% and 1.19%, respectively (p > 0.05). The net cumulative expulsion rates were 0.61% and 1.32% (p > 0.05). The net cumulative rates of removal for medical reasons were 2.37% and 1.97% (p > 0.05). The net cumulative removal rates for non-medical reasons were 1.80% and 10.38% (p < 0.001); the net cumulative continuation rates were 95.29% and 85.60% (p < 0.002). The net cumulative acceptance rates were 97.04% and 93.83% (p > 0.05). The Norplant users experienced less menstrual and inter-menstrual bleeding and more amenorrhea than the IUD group. The psychological satisfaction scores among the Norplant and IUD users were high (p > 0.05). The Norplant contraceptive is well accepted.

CONCLUSIONS

The findings could be very useful for further steps in promoting Norplant as a contraceptive that is long-acting, with good efficacy, acceptance, and safety.