Changes in menstrual and haematological indices among Norplant (R) accepters

A longitudinal study of women using Norplant(R) was conducted to determine the effects of levonorgestrel implants on menstrual and haematological indi ces among the accepters. Packed cell volume (PCV), white blood cell (WBC) c oncentrations (total and differential), and platelet concentration were per formed at pre-insertion and at the 12-month follow-up. Each acceptor receiv ed a menstrual calendar to chart all bleeding, and spotting events. The mean PCV was 40.5 +/- 2.4 at insertion and had a statistically signific ant (p < 0.01) rise so a mean value of 42.2 +/- 2.6 at 12 months. The mean WBC concentration had a significant decrease at 12 months (p < 0.001) when compared with the pre-insertion value. Similarly, the neutrophil and lympho cyte concentration had a statistically significant decrease (p < 0.05 and p < 0.01, respectively) at 12 months of use. The reduced values in the conce ntrations of monocytes, eosinophils and basophils did not reach significant levels. The mean value of the platelet concentrations had a significant de cline at 12 months of use (p < 0.001). Reduced bleeding patterns were more commonly reported compared to increased bleeding episodes. This pattern was associated with increased PCV, a change that may prevent anaemia in develo ping countries. The decline in the platelet concentration at 12 months of s tudy was, however, a source of concern that will require follow-up. (C) 200 0 Elsevier Science Inc. An rights reserved.