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.
Rivera
Roberto
R
Family Health International, P.O. Box 13950, Research Triangle Park, NC 27709, USA. rrivera@fhi.org
Rountree
Wes
W
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