[Evaluation of the contraceptive implant method: statistical considerations and medical and psychosocial aspects]

In searching for new hormonal contraceptive methods substances belonging to the progestin group and being active at low dosages have been studied for several years. Excellent results were obtained with Norgestrel releasing doses of 30 mcg per day and seemingly obtaining a pearl index of 0.16 and which distributes within the organism especially in the subcutaneous fat and in the genital organs with special intensity in the muciparous glands. It is indicated for those women who do not tolerate estrogenic components and for those who need a simple and efficient method (e.g. rural population). The pharmaceutical does not provoke metabolic alterations of the suprarenal tyroid pancreatic hormones nor mammary tension weight gain edema nausea and vomiting and only minor hepatic complications and effects on blood coagulation. It can be taken orally or through the vagina or by endouterine insertion using plastic capsules forming part of an IUD or by subdermal implant of a capsule. Norplant uses 6 implants of cylindrical capsules 3.4 cm long and 2.4 mm in diameter made of the polymer polydimethylsiloxane registered under the name Silastic. The capsules are generally inserted in the arm using an incision of ca. 5 mm under local anesthesia. After 24 hours of insertion the inhibitory effect on conception is attained which remains constant for more than 5 years with a mechanism identical to that of oral administration. The most frequent answer to why this method was preferred by a sample of women was the long duration of the effect after only 1 insertion. For the implantation of mestranol (estrogen component) patients responded with general satisfaction but irregular loss of blood sometimes abundant as well as amenorrhea were major inconveniences. Implant insertion during the puerperium is accepted it increases for instance protein content and quantity of the milk.