Contraception with long acting subdermal implants: II. Measured and perceived effects in international clinical trials

Abstract Hemoglobin levels, blood pressure, body weight and the subjects' impressions of changes in various conditions have been recorded during a multicentered study of levonorgestrel and norgestrienone subdermal implants. Data from a group of women using the Copper T 200 IUD at the same clinics and admitted under the same criteria are presented for comparative purposes. A major reason for termination of use of the levonorgestrel implants was disturbance of menstrual patterns. When all subjects reported their experience with the two steroid regimens, substantially larger proportions of subjects using levonorgestrel implants noted changes in menstrual flow, duration of menses and intermenstrual bleeding and spotting than was the case of women contracepting with norgestrienone implants. Relative to the experience with implants, more users of the Copper T 200 in a control study reported increased dysmenorrhea, and an increase in the amount and duration of menstrual flow. Despite the reported increases in menstrual flow and duration of bleeding, women using subdermal implants of either contraceptive steroid, levonorgestrel and norgestrienone, showed an increase in blood hemoglobin values during the course of one year of use. In the control group using the TCu 200 IUD, no change in mean hemoglobin levels was found. Neither mean systolic nor diastolic blood pressure of the women using steroids was affected. There was a small net increase in weight among the users of steroids, but none in the Copper T controls. An increase in acne and other skin conditions was perceived by the same percentages of women using Copper IUDs as women using the steroids. A greater proportion of IUD acceptors noted increased nervousness and depression than was felt by the women contracepting with the steroid implants.