Clinical assessment of treatments for prolonged bleeding in users of norplantR implants

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      The effectiveness of three drugs in controlling prolonged bleeding in the first year of NORPLANTR implants use was tested. The drugs were levonorgestrel (L-Ng, 0.03 mg twice a day for 20 days), ethinylestradiol (EE, 0.05 mg per day for 20 days) and ibuprofen (Ib, 800 mg three times a day for 5 days) and were given orally. A control group received a placebo (PL, one pill of lactose for 20 days). Treatment should start each time a woman experienced eight consecutive days of bleeding or spotting. The 183 volunteers were not aware of the drug administered. A daily record of bleeding and spotting and of treatment intake was maintained. One-hundred-forty women completed the study period; 60 never used the prescribed treatment. Women treated with the three test drugs had significantly fewer bleeding and spotting days during the treated month and also throughout the study year than women using the placebo. The mean number of bleeding plus spotting days per actually treated subject in the first year was 77, 94, 101 and 129 days for the EE, Ib, L-Ng and PL groups, respectively. The administration of EE might help in the management of prolonged bleeding during the first year of NORPLANTR implants use.
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        • Sivin I
        • Robertson DN
        • Stern J
        • et al.
        Norplant, reversible implant contraception.
        Stud Farn Plann. 1980; 11: 227-235
        • Sivin I
        International experience with NorplantR and NorplantR−2 contraceptives.
        Stud Fam Plann. 1988; 19: 91-94
        • Faúndes A
        • Sivin I
        • Stern J
        Long-acting contraceptive implants: an analysis of menstrual bleeding patterns.
        Contraception. 1978; 18: 335-365
        • Diaz S
        • Pavez M
        • Robertson DN
        • Croxatto HB
        A three-year clinical trial with levonorgestrel Silastic implants.
        Contraception. 1979; 19: 557-573
        • Weiner A
        • Johansson EDB
        Plasma levels of d-norgestrel, estradiol and progesterone during treatment with Silastic implants contanining d-norgestrel.
        Contraception. 1976; 14: 81-92
        • Moore DE
        • Roy S
        • Stanczyk FZ
        • Mishell DR
        Bleeding and serum d-norgestrel, estradiol and progesterone patterns in women using d-norgestrel subdermal polysiloxane capsules for contraception.
        Contraception. 1978; 17: 315-328
        • Shaaban MM
        • El-Nashar IM
        • Ghaneimah SA
        • Gomaa AA
        • Salah M
        • Abdel-Aleem AM
        Hormonal changes during the first year of use of subdermal levonorgestrel implants, NorplantR.
        Contraception. 1984; 30: 391-405
      1. Alvarez F, Brache V. Unpublished.

        • Robertson DN
        • Diaz S
        • Alvarez-Sánchez F
        • et al.
        Contraception with long-acting subdermal implants. A five-year clinical trial with Silastic covered rod implants containing levonorgestrel.
        Contraception. 1985; 31: 351-359
      2. Sivin I. Unpublished.

        • Weiner E
        • Johansson EDB
        Contraception with d-norgestrel Silastic rods: Plasma levels of d-norgestrel and influence on the ovarian function.
        Contraception. 1976; 14: 551-562
        • Brache V
        • Faúndes A
        • Johansson EDB
        • Alvarez F
        Anovulation, inadequate luteal function and poor sperm penetration in cervical mucus during prolonged use of NorplantR implants.
        Contraception. 1985; 31: 261-273
        • Croxatto HB
        • Díaz
        • Salvatierra AM
        • Morales P
        • Ebensperger C
        • Brandeis A
        Treatment with NorplantR subdermal implants inhibits sperm penetration through cervical mucus in vitro.
        Contraception. 1987; 36: 193-201
        • Croxatto HD
        • Diaz S
        • Pavez M
        • Croxatto HB
        Histopathology of the endometrium during continuous use of levonorgestel.
        in: Zatuchni GL Goldsmith A Shelton D Sciarra JJ Long-Acting Contraceptive Delivery Systems. Harper & Row Publishers, Philadelphia1984: 290-295
        • Croxatto HB
        • Diaz S
        • Pavez M
        • Miranda P
        • Brandeis A
        Plasma progesterone levels during long-term treatment with levonorgestrel Silastic implants.
        Acta Endocrinol. 1982; 101: 307-311