Irregular bleeding, body mass index and coital frequency in Norplant contraceptive users.

ABSTRACT

PIP: Medical researchers recruited 75 women to participate in a 5-year prospective study of Norplant use that examined their bleeding patterns, changes in Body Mass Index (BMI), the effect BMI had on the bleeding pattern, and the effect irregular bleeding had on coital frequency. Clinicians took a complete medical and sexual history and performed a physical and pelvic examination. Follow up visits occurred at 1, 3, 6, and 12 months after insertion of the Norplant contraceptive implant and every 6 months thereafter until removal at 5 years. The clients maintained a daily record of coital activity and bleeding/spotting patterns. Thirty women completed 5 years of Norplant use. Irregular bleeding occurred most frequently during the 1st 2 years of Norplant use. Its frequency decreased as duration of Norplant use increased. For example, 22.35% of the women experienced spotting and bleeding between menstrual periods in the 1st year, 12.25% in the 2nd year, and 3.1% at 5 years. BMI was similar for women with and without irregular bleeding patterns. BMI did not change significantly over the 5 years. Irregular bleeding did not affect coital frequency. The mean coital frequency for the women was 18-20 acts of sexual intercourse per month. Irregular bleeding (32%) and planned pregnancy (12%) were the leading reasons for discontinuation of Norplant. Most of the women who quit using Norplant for irregular bleeding reasons did so during the 1st 2 years. Just 5 pregnancies occurred during Norplant use. These results suggest that clinicians should adequately counsel potential Norplant users about irregular bleeding to reduce discontinuation for irregular bleeding.