The introduction of a new contraceptive; two years experience with Norplant.

OBJECTIVE

To determine the uptake, acceptability and continuation rates of a new contraceptive implant, Norplant.

DESIGN

Review of case notes of all acceptors during the two years following the introduction of the implant.

SETTING

A large family planning clinic in Edinburgh.

SUBJECTS

All women choosing Norplant.

RESULTS

508 women chose Norplant, many as an alternative to sterilisation or because they had experienced problems with other methods of contraception. 9% of women were lost to follow-up. Of the remainder continuation rates were 84% at one year and 80% after 18 months of use. 43% of women gave bleeding problems as the reason for removal. However the combination of weight gain, mood swings, depression and headache was frequently reported as unwanted side effects by women seeking removal. No major problems were experienced with either insertion or removal of Norplant.

CONCLUSIONS

Norplant is an effective method of contraception which many women find attractive. The incidence of erratic bleeding is high but many women tolerate this problem because the method is easy to use and lasts five years. Careful counselling is essential for high continuation rates.