Blood-lipid fractions: the side-effects and continuation of Norplant use.
OBJECTIVE
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.
Noerpramana
N P
NP
Department of Obstetrics and Gynaecology, Medical Faculty, Diponegoro University, Dr Kariadi Hospital, Semarang, Central Java, Indonesia.
D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D002784:Cholesterol / Q000097:blood; D016001:Confidence Intervals; D003271:Contraceptive Agents, Female / Q000592:standards*; D004343:Drug Implants; D005260:Female; D006801:Humans; D007214:Indonesia; D007434:Intrauterine Devices / Q000592:standards; D016912:Levonorgestrel / Q000009:adverse effects*; D016014:Linear Models; D008055:Lipids / Q000097:blood*; D008075:Lipoproteins, HDL / Q000097:blood; D008599:Menstruation Disturbances / Q000097:blood / Q000139:chemically induced; D010146:Pain / Q000097:blood / Q000139:chemically induced; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D045167:Progesterone Congeners / Q000009:adverse effects*; D011446:Prospective Studies; D012306:Risk; D018401:Sample Size; D016019:Survival Analysis; D013997:Time Factors; D014280:Triglycerides / Q000097:blood
D003271:Contraceptive Agents, Female; D004343:Drug Implants; D008055:Lipids; D008075:Lipoproteins, HDL; D045167:Progesterone Congeners; D014280:Triglycerides; D016912:Levonorgestrel; D002784:Cholesterol