Slide 3
Typically, the frequency of bleeding changes, especially irregular and
prolonged bleeding, decreases with time and is less of a problem by the end of the first
year. In this study, 66% of the women had irregular bleeding, 27% regular bleeding and 7%
were amenorrheic in the first year. By the fifth year, only 38% had irregular bleeding
while 62% had regular bleeding and none were amenorrheic.
Slide 5
Dysynchronous refers to a histological picture when the endometrium is composed of
endometrial cells at different stages of development, ranging from proliferative to
secretory.
Slide 8
Thorough counseling has been shown to decrease discontinuation as a result of changes
in bleeding patterns. This study compared groups of Norplant users over two time periods,
1975-1978 (Group 1) and 1982-1983 (Group 2). Group 2 received counseling before and after
insertion of the implants about all the side effects and potential problems during use,
partly because the clinic staff had more experience and more confidence in Norplant. As
shown in the graph, the group that received more thorough counseling had much lower
discontinuation rates.
Slide 9
The columns in the above table are as follows:
- Duration is the number of days that the treatment was given.
- Cycles is the mean number of treatments per year.
- Rx Days is the mean number of day per year that treatment was given (product of duration
multiplied by cycles)
- Reduction in B/S days is the mean number of days of reduction in bleeding and spotting
per year.
Slide 17
Among women using Norplant Implants, 82% experienced a change in their menstrual
bleeding pattern, however, only 27% reported this side effect as bothersome. A smaller
number of women reported that other side effects were most bothersome.
