Progestin is a synthetic hormone similar to the progesterone made by a woman's ovaries. The progestin in Norplant works in two ways. Usually, it thickens the cervical mucus, preventing sperm from joining with an egg. Less often, it keeps the ovaries from releasing an egg (ovulation).

It is the most effective method of birth control ? except for continuous abstinence. Of every 10,000 women who use Norplant, fewer than five will become pregnant in the first year of use. Left in place, Norplant can protect against pregnancy for up to seven years. The effectiveness of Norplant decreases after five years for overweight women. All women should talk to their health care provider after using Norplant for five years to find out if continued use is an option.

How Implants Are Used

Do not have implants inserted if there is a chance that you are pregnant. Be sure to tell your clinician if you think there is any chance that you are.

Your clinician will advise you to have a follow-up visit within the first three months after insertion. It is best to have follow-up visits once a year after that. Be sure to tell any health care provider you may see that you are using Norplant.

Norplant should be removed after seven years ? five years for overweight women ? because it stops working, and it can cause menstrual irregularities. It can also be removed anytime earlier. The clinician will numb the area with a painkiller and will usually make one small cut to remove all six of the implants. Removal takes up to 30 minutes. Norplant may be more difficult to locate in some women. Removal for them may require more than one visit and/or several incisions. Pregnancy can happen anytime after the implants are removed.

Advantages of Implants

• can be used by women who cannot take estrogen
• nothing to put in place before vaginal intercourse
• can be used while breast-feeding
• gives continuous long-lasting birth control without sterilization ? for seven years
• no medicine to take every day
• ability to become pregnant returns quickly when use is stopped

• cannot stand irregular bleeding or spotting
• has a sensitivity to the ingredients in Norplant
• cannot put up with irregular bleeding or loss of her period
• wants to become pregnant within one year
• has unexplained bleeding from the vagina
• is or might be pregnant
• has had breast cancer

• have worsening depression
• have a recent history of liver disease, such as hepatitis, or abnormal results on liver function tests
• take medication to control seizures

Possible Disadvantages of Implants

• irregular intervals between periods
• longer or heavier menstrual flow
• irregular bleeding or spotting between periods
• no menstrual bleeding for months at a time

Less common side effects include

• headache
• nausea
• dizziness
• sore breasts
• acne, skin rash
• change in appetite, weight gain
• depression
• hair loss or increased hair on the face or body
• nervousness
• cysts on the ovaries
• discoloring or scarring of the skin over the implants
• risks of minor surgery
• removal is sometimes difficult, requiring more than one appointment

• late or missed periods
• severe lower abdominal pain
• nausea and breast tenderness

Implants provide no protection against sexually transmitted infections. Latex and female condoms can reduce the risk of infection.

Warning Signs for Implants

Serious problems are rare. Tell your clinician immediately if you have

• severe pain in the stomach or abdomen
• unusually heavy or prolonged vaginal bleeding
• a new lump in your breast
• pus, bleeding, and increasing redness or pain at site insertion
• a capsule come out
• arm pain
• a migraine or other severe headache

What Implants Cost

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