Menstrual bleeding patterns in Chinese women using the Norplant subdermal implant

An analysis of the menstrual diary records of 306 cases of Norplant users over 5 years is reported. The results indicate that the disturbances of menstrual cycles during Norplant use were mainly caused by changes in the total number of vaginal bleeding days. Menstrual patterns were irregular and prolonged. Disturbances of the menstrual pattern were improved after 6-12 months of use, mainly showing a decrease in the number of spotting days. About 30-40% of users may regain their normal menstrual pattern after 1 year of use. There was a proportion of cases with an abnormal menstrual pattern throughout the 5 years of use, but the gross cumulative termination rate for menstrual problems was only 13.0%. Norplant users are susceptible to an increase in the number of spotting days and irregular bleeding. The main reason for termination of contraceptive use was prolonged bleeding for a long time. This is important information that should be provided in counselling potential Norplant acceptors, especially the changes in menstrual pattern. We also have a responsibility to try to find a treatment for prolonged bleeding.