Norplant for Birth Control

University of Iowa Hospitals and Clinics
Department of Obstetrics and Gynecology
Peer Review Status: Internally Peer Reviewed
First Published: 1994
Last Revised: December 2002

How does Norplant prevent pregnancy?
The hormone is released continuously from the capsules. Pregnancy is prevented primarily by altering ovulation and by thickening cervical mucus, which helps block the passage of sperm. It is thought that in a few cases, the hormone causes changes in the lining of the uterus that makes it unreceptive. However, this is difficult to predict since six of ten fertilized eggs never attach to the uterine wall when no contraceptive measures are used.

What are the benefits for Norplant?
Norplant is an effective form of long-term birth control. It has been shown to be more effective than combination birth control pills and slightly less effective than permanent sterilization (tubal ligation/vasectomy). The pregnancy rate in the first year of use is 2/1000. Over five years of use the pregnancy rate is about 3-5/1000. Unlike permanent sterilization Norplant is reversible. Most women's fertility returns to their pre-Norplant level soon after removal. Women who have a hard time remembering to take birth control pills regularly may enjoy the convenience of Norplant.

What are the drawbacks to Norplant?
The most common side effect is menstrual irregularities. These irregularities can vary from woman to woman and include absence of periods, heavy periods, bleeding between periods or a combination of these. These side effects occur in 30 to 50 percent of women and generally periods become more regular after 6 to 12 months of use. Similar to the birth control pills, a small number of patients have reported headaches, nausea, dizziness, appetite changes, breast tenderness, weight change and increased hair growth.

Does my weight or age affect my use of Norplant?
There are no age limits on the use of Norplant. Women who weigh more than 154 pounds have a slightly higher failure rate while using Norplant. Over five years of use the failure rate is about 8/1000.

Can Norplant be used by nursing mothers?
Norplant can be used by nursing mothers six weeks after delivery. It can be placed immediately post partum in women who choose to bottle feed.

Who should not use Norplant?
Women who are pregnant or have abnormal vaginal bleeding for unknown reasons should not use Norplant. Women with a history of liver disease, heart attack, stroke, severe headaches for unknown reasons, breast cancer, seizure disorders controlled by anticonvulsants or blood clots in lungs, legs or eyes should not use Norplant.

When and how should Norplant be inserted?
Insertion should be done during the first seven days of the menstrual cycle to prevent its placement in a pregnant woman. When inserted this early in the menstrual cycle, contraceptive coverage begins in 24 hours. Norplant capsules are inserted in the doctor's office, using local anesthetic to numb the area. During the 10- to 15-minute procedure the capsules are placed in a fan-shape formation under the skin, through a hollow needle. This is a minor surgical procedure and there may be some bleeding, bruising and soreness.

When and how is Norplant removed?
Norplant can be removed at any time, but is not effective five years after placement. The removal is done in the doctor's office and takes 20-30 minutes. The capsules are removed through a small incision. A new set of capsules can be inserted at the time of removal.

See related Patient Textbooks about Obstetrics and Gynecology.

See related Patient Topics Birth Control/Contraception, Family Planning, Men's Health, Obstetrics and Gynecology, Pregnancy and Reproduction or Women's Health.

See related Provider Textbooks about Obstetrics and Gynecology.

See related Provider Topics Birth Control/Contraception, Family Planning, Men's Health, Obstetrics and Gynecology, Pregnancy and Reproduction or Women's Health.

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