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Norplant failure: an adolescent case study and review of the literature
1Adolescent Health Services, Methodist Hospital of Indiana, Indiana University School of Medicine, Indianapolis, USA.
Study Objective:
To alert clinicians to risk factors associated with levonorgestrel implant (Norplant; Wyeth-Ayerst Laboratories, Philadelphia, PA) failures in the adolescent population and discuss alternatives.
Data Sources:
Medline search of articles pertaining to the use of levonorgestrel implants in the adolescent population.
Study Selection:
All articles pertaining to the use of levonorgestrel implants in adolescents.
Conclusions:
Levonorgestrel subdermal implants, Norplant, have been successfully used worldwide as contraceptives. Clinical trials suggest that pregnancy rates while using levonorgestrel implants are positively correlated with increased body weight. In addition, pregnancy rates may be higher in women below age 25 years. Finally, patients who report regular menstrual cycles on levonorgestrel implants may be at greater risk for method failure. Consequently, despite its apparent success, levonorgestrel implants have some significant but little-known limitations that should be considered in initial adolescent patient selection, education, and postinsertion medical supervision.