Skip to main content
SpringerLink
Log in

Blood-lipid fractions: the side-effects and continuation of Norplant use

  • Published:
Advances in Contraception

Abstract

Objectives: Norplant has been widely used in Indonesia, though a previous study conducted in Jakarta indicates that there is a significantly high cholesterol level in acceptors. Other international studies indicate different results. Accordingly, a study on the fraction of blood lipids of Norplant acceptors was considered necessary.

Material and procedures: A prospective cohort comparative study was conducted in the Dr Kariadi General Hospital and Primary Health Center at Gunungpati. Clinical and laboratory observations were done by means of pre-post test design. Norplant acceptors were treated as the case group while IUD acceptors were the control group. Cholesterol level, triglyceride, HDL, LDL, and ratio of cholesterol:HDL, side-effects and continuation of use were evaluated.

Results: The subjects were 91 Norplant and 89 IUD acceptors. Norplant acceptors showed the following study results: Total cholesterol showed a slight decrease (165.06-132.80 mg/dl), triglycerides were slightly increased (76.23-81.87), HDL showed a decrease (45.55-38.85), and so did LDL (105.75-78.55); the ratio of cholesterol:HDL remained constant (3.75-3.78) and all fraction levels of blood lipids were within the limit of tolerance and did not exceed the critical value. Normal menstrual blood flow remained constant, but heavy menstrual blood flow decreased. The cycle of normal menstruation was reduced and the inter-menstrual bleeding and the 2-3 month menstrual cycle were increased. Complaints of dizziness/headache, leucorrhea, and pain at insertion were all relatively few. There was no change of body weight and blood pressure. Continuation of use was 100%.

Conclusions: The fraction of blood lipids found indicates varied results though blood lipids are still below critical values; it can be concluded that there is no risk of coronary heart disease.

The continuation rate of Norplant use was high, due probably to side-effects counseling, and the social and cultural circumstances of acceptors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. National Family Planning Coordinating Board. Indonesia. An overview of the National Family Planning Program, Jakarta, 1984.

  2. Affandi B. Clinical, pharmacological and epidemiological studies on a levonorgestrel implant contraceptive. Indonesia University, Disseration; 1987.

  3. The Population Council. Longacting progestins-promise and prospects. Injectable and implants. Population Reports, May 1983.

  4. The Population Council. Contraceptive subdermal implants. Norplant worldwide. The Population Council, August 1986.

  5. 5. The Population Council. Hormonal contraception: new longacting methods. Injectable and implants. Population Report, April 1987.

  6. The Population Council. Contraceptive subdermal implants. Norplants worldwide. The Population Council, August 1987.

  7. The Population Council. Contraceptive subdermal implants. Norplants worldwide. The Population Council, November 1987.

  8. Noerpramana NP, Praptohardjo U. The experience of women who have completed one year of Norplant use. The Sixth Indonesian Congress of Obstetrics and Gynecology, Ujung Pandang, Indonesia, June 1985.

    Google Scholar 

  9. Noerpramana NP, Binarso A, Praptohardjo U, Soediyanto SS, Zaini H. The experience of women who have completed year one of Norplant use. The Sixth Indonesian Congress of Obstetrics and Gynecology, Ujung Pandang, Indonesia, June 1985.

    Google Scholar 

  10. Noerpramana NP. Pelatihan dan Pelayanan Pencabutan Norplant di RS Dr Kariadi Semarang. Majalah Obstetri dan Ginekologi Indonesia. 1991;17:22–34.

    Google Scholar 

  11. Noerpramana NP. An experience on the use, removal and reinsertion of Norplant in Central Java, Indonesia. Majalah Kedokteran Diponegoro. 1993;25:229–39.

    Google Scholar 

  12. Wijaya A. Gangguan Metabolisme lemak dan Penyakit Jantung Koroner. Diagnosis, Pencegahan Penanggulangan. Program Pustaka Prodia serie Lipid 01; 1991.

  13. Lipid Research Clinic Program. The Lipid Research Clinics Coronary Primary Prevention Trial results: II. The relationship of reduction in incidence of coronary heart disease to cholesterol lowering. J Am Med Assoc. 1984;251:365–74.

    Google Scholar 

  14. Castelli WP, Garrison RJ, Wilson PWF et al. Incidence of coronary heart disease and lipoprotein cholesterol levels: the Framingham Study. J Am Med Assoc. 1986;156:2835–8.

    Google Scholar 

  15. Castelli WP. The triglyceride issue: A view from Framingham. Am Heart J. 1986;112:432–7.

    Google Scholar 

  16. Croxatto H, Diaz S, Robertson DN et al. Clinical chemistry in women treated with levonorgestrel implants (Norplant) or a TCu 200 IUD. Contraception. 1983;27:281–8.

    Google Scholar 

  17. Roy S, Mishell Dr Jr, Robertson DN et al. Long term reversible contraception with levonorgestrel releasing silastic rods. Am J Obstet Gynecol. 1984;148:1006–13.

    Google Scholar 

  18. Holma P, Robertson DN. Cholesterol and HDL cholesterol values in women during use of subdermal implants, Norplant, on serum lipids. Contraception. 1984;32:163–71.

    Google Scholar 

  19. Shaaban MM, Elwan SI, Abdalla SA et al. Effect of subdermal levonorgestrel contraceptive implants, Norplant, on serum lipids. Contraception. 1984;30:413–9.

    Google Scholar 

  20. Phandhu-Fung, Kanchanaporn K et al. Clinical chemistry result in Norplants acceptors at Songklana-garind Hospital. Songklanagarind Medical Bulletin, 1988.

  21. Affandi B, Suherman SK et al. Serum lipid in Norplant implant user: a cross-sectional study. Contraception. 1987;36:429–34.

    Google Scholar 

  22. Liskin L, Blackburn R, Ghini R. Hormonal contraception: new long-acting methods. Population Reports, Series No. 3. 1987;15:58–84.

    Google Scholar 

  23. Djokomoeljanto. Hiperlipidemia: klasifikasi, gejala klinik dan pengelolaannya. Bagian Penyakit Dalam Fakultas Kedokteran universitas Diponegoro Semarang.

  24. DeBusk RF. Techniques of exercise testing. In: Hurst JW, Loque RB, Rackley CE et al., eds. The Heart: Arteries and Veins. New York: McGraw-Hill Book Co. 1990;19:1704–15.

    Google Scholar 

  25. La Rosa JC. The varying effects on progestins on lipid levels and cardiovascular disease. Am J Obstet Gynecol. 1988;158:1621–7.

    Google Scholar 

  26. Catelli WP, Garrison RJ, Wilson PWF et al. Incidence of coronary heart disease and lipoprotein cholesterol levels: the Farmingham Study. J Am Med Assoc. 1986;256:2835–8.

    Google Scholar 

  27. Wahl P, Walden C, Knopp R, Hoover J. Effect of estrogen/progestin potency on lipid/lipoprotein cholesterol. N Engl J Med. 1993;308:862–7.

    Google Scholar 

  28. Pocock SJ. Statistical aspects of clinical trial design. The statistician. Institute of Statisticians. 1982;31:1–18.

    Google Scholar 

  29. Dobson AJ. Calculating sample size. Transactions of the Menzies. Menzies Foundation. 1984;7:75–9.

    Google Scholar 

  30. Sivin I, Stern J. Long-acting, more effective copper T IUDs: A summary of US experience, 1970–1975. Stud Fam Plann. 1979;10:263–81.

    Google Scholar 

  31. Affandi B, Santoso SSI, Djajadilaga et al. Five-year experience with Norplant. Contraception. 1987;36:417–29.

    Google Scholar 

  32. Anwar M. An evaluation of IUD insertion by a non clinical delivery system. Newcastle, NSW Australia: Centre for Clinical Epidemiology and Biostatistics, February 1988, thesis.

    Google Scholar 

  33. The Population Council. IUDs update on safety, effectiveness, and research. Intrauterine devices. Population Reports. 1979:7(3).

  34. The Population Council. IUDs — An appropriate contraceptive for many women. Intrauterine devices. Population Reports. 1982:10(4).

  35. Koetsawang S, Varakamin S, Satayapan S, Dusitsin N. 1985 Norplant clinical study in Thailand, Norplant introduction meeting. Department of Health Ministry of Public Health, Bangkok, Thailand, June 1–2, 1985.

  36. Salah M, Admed AGM, Eloyoun MA, Shaaban MM. Five-year experience with Norplant implants in Assiut, Egypt. Contraception. 1987;35:543–50.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Medical Faculty, Diponegoro University, Dr Kariadi Hospital, Semarang, Central Java, Indonesia

    N.P. Noerpramana

Authors
  1. N.P. Noerpramana
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Noerpramana, N. Blood-lipid fractions: the side-effects and continuation of Norplant use. Advances in Contraception 13, 13–38 (1997). https://doi.org/10.1023/A:1006512211238

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1006512211238

Keywords

Search

Navigation