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Title: Adolescents and Norplant: preliminary findings of side effects.
Author: Kozlowski KJ, Rickert VI, Hendon A, Davis P.
Journal: J Adolesc Health; 1995 May; 16(5):373-8. PubMed ID: 7662687.
Abstract:
PURPOSE: The purpose of this study was to investigate side effects such as menstrual irregularities, weight gain, and blood pressure changes among adolescent females who had been implanted with Norplant eight or more months. METHOD: A retrospective chart review was completed on adolescents who received care through an outpatient adolescent gynecology service. Subjects (n = 110) with an average age of 17.2 years were implanted with Norplant between March 1991 and February 1992. The mean length of time since implantation was 12.7 months and 64% were African-American. Data collected included: dates of all medical visits; presence of acne, mood changes, and menstrual patterns following implantation. Measurements of blood pressure and weight were taken at implantation and at all subsequent visits. RESULTS: Weights for Caucasian females at the last visit were significantly higher than at baseline (P < .02). With regard to the African-American females' weight, significant differences were found between baseline weight and each follow-up visit. Although we could not determine the bleeding patterns in 22% of our study sample, almost 40% of the adolescent females followed reported their bleeding to be light as well as regular and cyclic. CONCLUSION: Weight gain was the most frequently observed side-effect of Norplant in adolescents in this study. To learn more about the side effects associated with Norplant use in adolescence, the charts of 110 women 13-21 years of age (average, 17.2 years) who received the implants through hospital-based adolescent gynecology clinics in Arkansas were reviewed. The implants were inserted between March 1991 and February 1993; the mean length of time since insertion was 12.7 months (range, 8-19 months). 64% of Norplant acceptors were African-American. Weight and blood pressure measurements were obtained at baseline and at three follow-up periods: 1-4 months, 5-7 months, and 8 or more months. Overall, the average weight gain was 3.3 kg, but there were significant racial differences. At follow-up one, African-American females showed an average weight gain of 1.4 kg compared to no gain among White females. At follow-up three, the mean weight gain was 5.4 kg for African Americans and 2.6 kg for White youth. 37% of all participants reported no change in menstrual patterns, 28% experienced irregular (mainly light) bleeding, and 13% were amenorrheic; no data were available for the remaining 22%. There were no significant changes over time in blood pressure, and acne and depression were each recorded in only one chart. Three women requested Norplant removal during the study period. Overall, the findings of this study suggest that Norplant-related side effects may be less severe among adolescents than adult women, most notably the incidence of bleeding irregularities (82% in adult Norplant acceptors). To ensure Norplant continuation, however, adolescents should be counseled about the possibility of slight weight gain and light bleeding.

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