Clinical Experience with Levonorgestrel Subdermal Implants (Norplant) 1 for Long-Term Contraception
Emanuel Cardamakis, N A. Georgopoulos, A P. Pappas, A Fotopoulos, G P. Sykiotis, D Vassilios, A. Tzingounis
Clinical Drug Investigation 21(12): 827-834
2001
ISSN/ISBN: 1173-2563 DOI: 10.2165/00044011-200121120-00005Document Number: 499770
Objective The study was undertaken to assess the efficacy, acceptability and tolerability profile of levonorgestrel 6-capsule subdermal implants (Norplant®) for long-term contraception, in Greek women. Design Over a 6-year period, 72 women voluntarily seeking contraceptive advice from our clinic opted for long-term contraception with the levonorgestrel subdermal implant method after receiving counselling. In order to study the long-term effects of the implants, all women were advised to present for follow-up visits at 3 days after implantation, and at 1, 3, 6 and 12 months and every year for the remaining 4 years. Blood pressure, menstrual disorders and adverse effects were recorded at every visit, as were plasma glucose levels and serum levels of total cholesterol, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein-cholesterol and triglycerides. Results The mean follow-up period was 34.9 months (range 6 to 60 months), with a continuation rate of 95.5% for the first year and 94.9% for the second year. Neither normal nor ectopic pregnancies were observed. No significant change in blood pressure was observed, which ranged within normal values (≤140/90mm Hg). Significant increases (p < 0.01) in total cholesterol levels at 12 months (from 156.8 ± 34 mg/dl to 174.2 ± 32 mg/dl) and HDL-cholesterol levels at 6 months (from 58.5 ± 11.1 mg/dl to 60.5 ± 10.8 mg/dl) were observed. These levels returned to baseline values after 29 to 36 months. Adverse effects were reported in a minority of patients and included headache, decreased libido, bodyweight gain and nervousness. Conclusion The present study has shown that levonorgestrel subdermal implants are well accepted by Greek women and can be provided safely.