What It Is and How It Works

Thin, flexible plastic implants (5-6) are inserted under the skin of the upper arm. The soft capsules are about the size of a cardboard matchstick. Each contains a hormone (levonorgestrel) like the progesterone made by a woman's ovaries.

v     A small amount of hormone is released constantly. The hormone keeps the ovaries from releasing eggs. It also thickens the cervical mucus, keeping sperm from joining with an egg. Some researchers believe that Norplant may also work by preventing a fertilized egg from attaching to the lining of the uterus. Norplant protects against pregnancy for five years.

v     The implants release small amounts of hormone into the bloodstream. The bloodstream carries the hormone to the pituitary gland in the brain and to the uterus and cervix.

v     The hormone also keeps sperm outside the uterus by thickening the cervical mucus and thinning the lining of the uterus.

Norplant is one of the most effective reversible methods of birth control available in the U.S. It becomes effective within 24 hours of insertion. It protects against pregnancy for five years. Of every 100 women who use Norplant for five years, fewer than four will become pregnant - this is less than one per year. Norplant is actually slightly more effective than sterilization, but the contraceptive effect of Norplant disappears in a few hours after the implants are removed.

How To Get It

You must see a doctor or nurse practitioner to find out if you can use Norplant. The clinician will discuss your medical history with you. You will be given a physical exam, including:

·        blood pressure check

·        breast exam

·        pelvic exam

·        Pap test (to check for cancer of the cervix).

How It Is Inserted

If Norplant is right for you, the doctor will wash the skin with an antiseptic and numb a small area of your arm with a painkiller. The doctor will make one small cut. The six capsules will be inserted under the skin of the arm you use least. You need all six capsules to prevent pregnancy. Insertion takes about 10 minutes. It is painless, except for the needle prick of the painkiller, although some women feel some discomfort for a while after insertion.

Norplant usually is inserted during the first seven days after the start of your period. This is to be certain you are not pregnant. Be sure you use another form of birth control until the insertion is done. Norplant can be inserted immediately after an abortion or when an old set of implants is removed. It can be inserted at any time of the month if you are using the Pill or IUD. It also can be inserted right after an abortion or childbirth if you are not breastfeeding. If you are breastfeeding, you can use Norplant six weeks after childbirth.

After insertion, your doctor will advise you to avoid heavy lifting and to wear a bandage for a few days. You may have a temporary bruise at the insertion site and you may have some discomfort for a few days.

You also will be advised to make a follow-up visit within the first three months after insertion. This is to make sure that you are not having any problems. It is best to have follow-up visits once a year after that.

Remember to tell any health care provider you may see that you are using Norplant.

How It Is Removed

Norplant must be removed after five years when it stops working. It can be removed anytime earlier, as you wish.

For removal, your doctor will numb the area with a painkiller. One small cut will be made to remove all six of the implants. Sometimes, several incisions are needed because the implants may be more difficult to locate in some women. Removal takes longer than insertion - usually from 15 to 20 minutes, and more than one visit may be required. New implants may be inserted at this time. Women who are susceptible to scarring may be scarred during the removal process.

Unless you want to become pregnant, be sure to use another form of birth control if Norplant is removed.

Women Who Can Use Norplant

These include women who:

·        want continuous, long-acting birth control

·        do not want to take a pill daily or put a contraceptive in place before having vaginal intercourse

·        do not want to use a method that contains estrogen

·        can put up with some irregular bleeding and spotting

Women Who Can Use Norplant Only Under Medical Supervision

Women who use Norplant should be checked regularly by their clinicians if they have:

·        diabetes

·        high cholesterol or blood pressure

·        heart disease

·        seizures that require medication

·        serious depression

·        conditions that may be aggravated by fluid retention

·        serious liver disease.

Women Who Should Not Use Norplant

These include women who:

·        may be pregnant

·        have unexplained bleeding from the vagina

·        are breastfeeding in the first six weeks after delivery

·        have blood clots or inflammation of the veins

·        have had growths of the liver

·        have ever had breast cancer

·        cannot put up with irregular bleeding or spotting

·        have a particular type of high blood pressure ¾ idiopathic intracranial hypertension

·        have a sensitivity to the ingredients in Norplant.