Use of Norplant in Pakistan: two years experience

The acceptability and efficacy of norplant (levonorgestrel sub- dermal implants) was assessed over a period of two years among 445 married women aged 19 to 45 years. Twenty women were lost to follow-up while the remaining 425 were regularly followed-up. At the end of two years, 388 women were still continuing with norplant (91.2%). During this period, there was only one pregnancy (0.26%). There was no significant change in mean systolic or diastolic blood pressure. However, there was a significant increase (P < 0.001) in mean weight and decrease (P < 0.001) in the mean duration of menstrual cycle. Thirty-seven women (8.7%) got the implant removed. The major reason for removal (67.6%) was menstrual disturbances. Nine acceptors (18.59%) developed side effects, which were related to the type of symptoms often associated with steroid contraception. These findings are similar to those reported from other countries. The high efficacy (99.74%) and acceptability (continuation rate of 91.29%) as well as long acting (5 years) nature of norplant suggest that this method of contraception can safely be promoted in Pakistan.