The Norplant implant system is a set of 6 matchstick sized, hormone-containing capsules made of flexible tubing. The tubing is a blend of silicone and plastic called Silastic. The capsules are inserted by a trained professional just below the skin of a woman's upper inner arm (the part of the arm that lies against the side of the rib cage when the arms are at rest). The doctor uses a device that looks like a syringe (called a "trocar") to place the capsules in a fan-like shape. Thin women will probably be able to see the capsules under the skin once they are inserted, but for most others they aren't noticeable.
Starting 24 hours after the capsules are placed under her skin, the user is protected from pregnancy by the progestin called levonorgestrel, which slowly leaks out of the capsules and enters the bloodstream. The implants contain no estrogen. They will continue to release progestin for up to 5 years. Because they are not biodegradable, they must then be removed. Your doctor can insert another set of implants at the same time the old set is removed, if you want to continue using the method.
The implants should be inserted within 7 days of the start of your menstrual cycle, just to make sure you aren't already pregnant. Although there is no evidence that the Norplant system will hurt a developing baby, most experts believe it's best not to expose it to hormones.
The insertion procedure is done on an outpatient basis. Your doctor will give you a local anesthetic to numb the area, then make a small incision. It takes about 15 or 20 minutes to place all 6 capsules. The area will probably be tender, bruised, or slightly swollen for a day or two.
If you want the implants removed—when the five-year effectiveness begins to wear off, you want to get pregnant, or you simply don't like the method—you will again need a minor outpatient surgical procedure. Removal is often more difficult than insertion, sometimes requiring 2 sessions before all 6 capsules are removed. Two visits are necessary when swelling of the surrounding tissue becomes an impediment to the doctor and a discomfort to you.
Removals often present a problem for doctors because your skin tissue forms an envelope around the implants, making them difficult to grab with the tweezer-like instrument often used to take them out. The tissue envelope, which gets thicker and harder to remove as time goes on, must first be disrupted before the capsules inside can be pulled out. Many clinicians can remove a set of six capsules in 30 minutes. Some take longer, while others complete the procedure in as little as 10 minutes.
Twenty-four hours after the capsules have been removed, your protection from pregnancy ends.
Many women and their doctors were dubious about the system's eventual success when it was first introduced in the United States. They wondered why women would want to have these tiny sticks buried beneath their skin. To their surprise, the odd new method became almost an instant hit. In just over 2 years, 750,000 American women have chosen the implant system.
Most of these women received the implants with the help of the Medicaid system or private insurers. Norplant implants do have high up-front costs; the kit itself will probably cost over $500, insertion costs can start at $100, and removal costs average $400 to $500. However, depending on where you live, the implants may cost less than or about the same as 5 years' worth of birth control pills.
| Norplant: Pros and Cons The irregular bleeding caused by Norplant implants is the biggest complaint among users. However, those who stop having periods altogether cite this as an advantage. Here's a summary of the implant's pros and cons: Advantages
Disadvantages
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