Five-year continuation rate and reasons for early removal of Norplant in Shiraz, Iran.

Norplant has been the focus of controversy in Iran because of its relatively high premature removal rate. This study assessed the reasons for Norplant removal and its 5-year continuation rate to clarify the determining factors on elimination of this method. Subjects were identified via a retrospective chart review of Norplant users in Shiraz, Iran who were followed for 5 years. The mean age and weight of acceptors were 23.6 +/- 4.1 years and 54.4 +/- 8.5 kg, respectively. The most common reasons for removal were menstrual disturbances and personal reasons (each 41%). The 5-year continuation rate was 45%; on average, Norplant capsules were in place for 4.1 +/- 0.09 years. Norplant has been shown to be an acceptable option in other Muslim countries, so the relatively high rate of removal in Iran could not be attributed to the Norplant itself, but is probably linked to other factors that are in need of improvement.