Published on: Thursday, August 15, 2002

Norplant users need to find other options

By Zenaida Serrano Espanol
Advertiser Staff Writer

Norplant features six silicone rods that are implanted in an arm. The rods release a hormone over a five-year period, helping prevent pregnancy. Advertiser library photo

After giving birth to two children 15 months apart, Melissa Niau-Pule decided it would be best to go on birth control.

From 1994 to 1999, the Wai'anae resident, now 26, successfully used Norplant, a device implanted under the skin of the arm that prevents pregnancy for five years. She was extremely happy with it.

"It really worked," Niau-Pule said.

But women like her who have used Norplant and may be interested in re-implanting the device will have to find another form of birth control. Despite a steady flow of interest in Norplant among Hawai'i women, Wyeth Pharmaceuticals, the company that supplied Norplant, announced late last month that it was permanently withdrawing the device from the market, citing business reasons.

"There's a large number of women who used it, liked it and will be sorry to see it go," said Dr. Tod Aeby, director of the OB/GYN residency training program at the University of Hawai'i's John A. Burns School of Medicine.

Ursula Penrose, director of patient services at Planned Parenthood of Hawai'i, said the decision was an unfortunate one for Hawai'i women. "We were very disappointed because it's a wonderful option for a lot of clients," she said.

Norplant was a good long-term method of birth control for women, Penrose said, because users don't have to make repeated decisions about taking action to make it effective.

Norplant, introduced in 1990, features six matchstick-size silicone rods that are implanted in a woman's arm. The rods release the hormone levonorgestrel over five years, preventing pregnancy. It is more than 99 percent effective.

But not all women who used Norplant found it to be perfect. Some women complained about side effects such as irregular menstruation and nausea, while others said they were scarred when doctors botched the insertion or removal of the rods.

"It's not for everyone," said Karen Young, a nurse practitioner at the Nanakuli clinic of the Wai'anae Coast Comprehensive Health Center. "But on the other hand, it worked successfully for many women."

Norplant was an option for women who did not want to deal with taking daily birth control pills, receiving contraceptive injections such as Depo-Provera every three months or using an intrauterine device, Young said.

The long-term method was also ideal for many teens and young women who wanted to complete high school and college without worrying about unwanted pregnancies, Young said.

The U.S. Food and Drug Administration has advised women using Norplant to see their doctors and to consider other birth control methods. Women who still have the implants can have them removed, and Wyeth will pay the cost of removal if the procedure is completed by the end of this year. For details, call Wyeth's Norplant System Information Line at (800) 364-9809.

But Aeby said that women who have the implants need not worry.

"Anybody who currently has Norplant, there's no need to be concerned," Aeby said. Women who are happy with it and have no problems with it can continue to use it through its five-year effective period.

Penrose and Young said they hope women may soon have the option of using a new generation of implants, including a two-rod version of Norplant that prevents pregnancy for at least three years.

That product, Jadelle, used in dozens of countries, was approved by the FDA in 1996 but is not yet marketed in the United States. Wyeth spokeswoman Natalie de Vane said the company is considering whether to introduce the device in the United States. < NT>