CONTRACEPTIVE OUTCOMES AMONG ADOLESCENTS PRESCRIBED NORPLANT IMPLANTSVERSUS ORAL-CONTRACEPTIVES AFTER ONE-YEAR OF USE

OBJECTIVE: Our goal was to evaluate both the continuation and pregnanc y rates and the side effects experienced during the first year of use by adolescents who selected Norplant implants as compared with those w ho chose oral contraceptives for contraception. Furthermore side effec ts experienced at 6 versus 12 months among Norplant implant users were compared to determine whether they diminished with continued use of t his method. STUDY DESIGN: We conducted a case-control study of 56 adol escents less than or equal to 18 years old who selected implants as co mpared with 56 age-matched controls who chose oral contraceptive pills during the same time period. RESULTS: Only 34% of patients prescribed oral contraceptives as compared with 91% of Norplant implant patients were still using their chosen method 1 year later. As a result 25% of oral contraceptive users became pregnant within 12 months as compared with none who selected Norplant implants. Side effects were reported by >80% of patients in both groups, with menstrual irregularities repo rted more often by Norplant implant users than by oral contraceptive u sers (73% vs 5%, p = 0.01). Furthermore, Norplant implant users gained more weight than oral contraceptive users (8.7 vs 4.2 pounds) and wer e twice as likely to have an abnormal Papanicolaou smear. Finally, lit tle diminution in side effects was observed during the second 6 months of Norplant implant use. CONCLUSIONS: These data confirm that Norplan t implants provide better protection against unintended pregnancy in a n adolescent population but may be associated with more side effects. Clinicians should be aware of these findings so they can adequately co unsel young patients about these two methods of contraception.