Characteristics of menstrual problems associated with Norplant discontinuation: results of a multinational study.
This paper presents a secondary analysis of 3419 Norplant users from 11 countries throughout Asia, Africa and Latin America. The main objective was to identify the menstrual problems associated with a high risk of early discontinuation of Norplant use. Eligible participants were divided into two groups: those who continued use (n = 2667) for the first 3 years and those who discontinued use because of bleeding or pain (n = 752) during the first 3 years of use. Menstrual characteristics of the women were compared between groups using a logistic regression model with generalized estimating equations. Flow duration of more than 7 days, excessive amount of flow, dysmenorrhea and intermenstrual bleeding for more than 7 days were associated with a significant risk of discontinuation. The highest risk was observed in association with flow duration of more than 7 days (adjusted odds ratios of 1.85, 2.01 and 2.20 at 1, 2 and 3 years, respectively). The appropriate management of prolonged or excessive bleeding, namely by continuous counseling, is essential for successful Norplant use.
Family Health International, P.O. Box 13950, Research Triangle Park, NC 27709, USA. rrivera@fhi.org
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D000328:Adult; D000349:Africa / Q000453:epidemiology; D001208:Asia / Q000453:epidemiology; D003376:Counseling; D004343:Drug Implants; D005260:Female; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D016912:Levonorgestrel; D016015:Logistic Models; D008599:Menstruation Disturbances / Q000453:epidemiology* / Q000209:etiology; D016312:Treatment Refusal / Q000706:statistics & numerical data*
D004343:Drug Implants; D016912:Levonorgestrel