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Birth control pills
Norplant vs. progestin-only pill
Originally Published: October 06, 1995 ~ Last Updated / Reviewed on: September 17, 2004
 
Dear Alice,

I started Ortho-Novum 7/7/7 when I was 17, and started having migraines almost immediately. During some of these migraines, the left side of my face and left arm would go numb. When I told my doctor, he said I needed to get off the pill immediately because I could have a stroke. He recommended Norplant, and I have had an implant for a little over two years now. I was under the impression that the danger from the pill was caused by the estrogen, and I was wondering if it would be safe for me to take a progestin-only pill.

— Mouth to arm

 

Dear Mouth to arm,

Please note: Norplant is no longer available on the market. The answer to follow was current at the time of its original publication.

Norplant is a long-acting progestin-only contraceptive. The Norplant implants are inserted into the woman's arm, and one implant gives up to five years contraceptive protection. Norplant implants provide few side effects or complications. The implants start out with a much higher dose of progestin than the progestin-only birth control pill, but after 1 to 1-1/2 years the level goes down to equal that of the pill and stays that way for the remaining five years.

The advantages and lack of side effects that you have with the Norplant implants would be similar for any other type of progestin-only contraceptive. This includes progestin-only pills and injectable progestin-only contraception. All three types of contraception offer these benefits:

  • Light periods; less cramping and pain
  • Decreased anemia
  • Decreased risk of endometrial and ovarian cancer and pelvic inflammatory disease (PID)
  • Immediate reversibility of contraceptive effects
  • Long term effective contraception
  • Not dependent on single acts of intercourse

What Norplant does offer over the progestin-only (or mini) pill is higher continuation rates. The percentage of women who continue to use Norplant at 1 year is 85 percent, compared to 70 percent for the progestin-only pill and Depo-provera. Also, Norplant and Depo-provera eliminate the difficulty of having to remember to take a pill every day at the same time.

The disadvantages to ALL progestin-only contraception include:

  • Menstrual cycle disturbance
  • Weight gain
  • Breast tenderness
  • Bone density decrease

In addition, for Norplant, both insertion and removal require a minor surgical procedure. Associated with this procedure is higher initial costs. Although over five years the costs associated with Norplant equal that of other contraceptive methods, the initial cost of Norplant can be prohibitive. Lastly, occasionally women have local inflammation or infection at the site of the implants.

If you're thinking about changing to another form of progestin-only contraception, have a talk with your gynecologist or women's health nurse practitioner, so that you can discuss your own individual circumstances, although at first glance, it seems as though you might want to keep the implants in for the full five years (if you continue to want to use contraception). If you are a Columbia student, you can make an appointment in Primary Care Medical Services by calling x4-2284 to get more information about all forms of birth control and contraception.

Alice

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