Norplant's Ovulation Suppression Breaks Down After Year One
This 1993 review looks at published research on Norplant, a hormonal birth control implant. The review is not a new study. The author reports that ovulatory cycles rose from 11.1% in year one to nearly half in years two through five. The paper covers how well Norplant works, its side effects, and patient consent.
Key Findings
Ovulation suppression was inconsistent over time. Ovulatory cycles occurred in 11.1% of cycles during year one, rose to 46.3% in years two through five, and reached 66.8% after that.
Endometrial samples showed disruption in nearly 90% of cases. The author writes that this makes Norplant an abortifacient and that how often it acts that way was not yet known.
Over five years, pregnancy counts per 100 users ranged from 0.2 in women under 110 pounds to 8.5 in women 154 pounds and over.
Discontinuation climbed with time in use. About 19% of users stopped in year one, most often for irregular bleeding, rising to 50.4% by year three and 70.5% by year five.
Reported side effects beyond bleeding changes included headache, nausea, dizziness, ovarian cysts in about 10% of users, acne, weight change, and hair changes.
Interpretation
This is a review article that pulls together published outcome papers on Norplant from the 1980s and early 1990s. The review presents no new patient data. The paper's byline lists the author as director of the institute behind NaProTechnology. The ovulation and effectiveness numbers come from other researchers' studies, cited here but not re-checked. The endometrial finding shows Norplant can act on the uterine lining. But the review does not measure how often that ends a pregnancy. The author says that rate was unknown at the time. The paper studied one older implant. The findings may not apply to every hormonal method used today.
RRM Context
RRM education separates two approaches. Suppressive medications manage symptoms without finding their cause. Restorative care looks for what is driving a woman's cycle or fertility symptoms. This review raises a related question. Does a woman understand what a contraceptive does in her body, beyond stopping pregnancy? The paper is older than today's NaProTechnology charting tools and today's implants.
Our editorial summary of this paper, not the article's abstract.
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