|This is the talk page for discussing improvements to the Levonorgestrel-releasing implant article.
This is not a forum for general discussion of the article's subject.
|This article is of interest to the following WikiProjects:|
- 1 Effectiveness
- 2 Serious side effects
- 3 Settlement of Norplant Lawsuits
- 4 Proposed Infobox for individual birth control method articles
- 5 Weight gain parameter in infobox
- 6 Vandalism
- 7 Relationship between Norplant and Norplant II (Jadelle)
- 8 New Zealand Funding approval
- 9 Medical Notes section
- 10 Third world countries
- 11 how?
- 12 Controversy section
- 13 NPOVN
- 14 Move to Jadelle
- 15 Requested move 22 August 2015
The 99-99.95% effectiveness rate is mentioned by numerous different sources, such as:
- Norplant Package Insert (PDF)
- Planned Parenthood
- ReproLine at John Hopkins
- Norplant Implants from Dr. M.J. Bovo
- Health Library: Norplant from the University of Montana
Serious side effects
More information would be useful. The article mentions "serious side effects" as a reason for the drug's withdrawal from the market, but not under the side effects category. If I have missed a side effect that could be considered "serious" in the list, it should still be more explicitly stated when talking about the drug's withdrawal.
re Difficulty in Norplant removal, and class-action lawsuits
As expected (based on experience with other contraceptives) a class-action lawsuit was filed on behalf of women severely or permanently injured by Norplant. The amended complaint, filed on November 5, 1993, alleges that Wyeth-Ayerst failed to warn users "about the difficulty of [Norplant] removal," and as a result, women "...were damaged...and...will require continuing medical care due to the difficulty with removal of NORPLANT."
The suit alleges nine breaches by Wyeth, including "negligence" and "consumer fraud," and asks that Wyeth improve its warnings to women, and devise a "sufficient training program" for those who insert Norplant. The plaintiffs also ask that a compensation fund be established for these and other women, similar to the funds established several years ago for women damaged by intrauterine devices,,, and proposed for women harmed by silicone gel breast implants.
Four women's unfortunate experiences while using Norplant are detailed in the complaint. One woman suffered "interrupted and/or heavy and continual menstrual flow, nausea, weight gain (20 pounds), and severe headaches." Sixteen months after Norplant insertion, the physician, who unsuccessfully attempted to remove the rods, closed the incision and told her to return again. Three months later, and after two additional failed attempts to remove the rods, she was forced "to undergo surgery, under a general anesthetic...to remove the Norplant implants," and she now "has severe scarring..."
A second woman gained 18 pounds, developed menstrual irregularities, excessive hair growth, acne, and emotional side effects (irritability) during her 13-month use of Norplant. The implant-removal surgery lasted for more than two hours and required two separate incisions. Her arm was "bruised and sore," and "...left with two ugly scars." She continues to consult a dermatologist for the acne.
During a third woman's 17 months on Norplant she "experienced abnormally long menstrual cycles," which progressed to lack of menstrual cycles, "....hot flashes, headaches, and a numbness and pain in her left arm" so severe that "she could not pick things up with her left hand..." Although she sought removal of the Norplant rods 15 months after insertion, doctors were unsuccessful in removing them, even after nearly one and one-half hours of surgery. Two months later two more surgeons finally removed the implants through two separate incisions. She now has "severe scarring" after the two painful removal surgeries.
A fourth woman's Norplant experience included "excessive bleeding for two weeks" (after insertion), with "nausea, dizziness, weight gain...migraine headaches, diminished sex drive...[and] irritability" for the 13 months the Norplant rods were in her arm. Four months after insertion she complained to her doctor about the side effects, and was told twice to wait for two months (an additional four months). She finally demanded removal of the Norplant rods ten months after they were inserted.
Dependent on public assistance, she was told that the clinic lacked government funds for Norplant removal, and to wait three more months until the next fiscal year. During these three months she failed to find a physician who would remove the implants. When government funds became available, she returned to the clinic and underwent one and one-half hours of surgery to remove only two of the six implants. The next month she endured three more surgeries, one lasting three and one-half hours with eight injections of anesthetic, yielding removal of only one implant. Another surgical attempt failed to remove any of the three remaining implants. She was referred to a specialist who recommended surgery under general anesthesia. Nearly five months after she asked for Norplant removal, the fourth surgery removed the remaining three implants. She now has "severe scarring" and arm pain.
Considering that the approximately 800,000 U.S. women who currently use Norplant will ultimately seek removal of the implants, it is unknown how many other women will experience problems similar to those of the women in the lawsuit. One could reasonably expect that the longer the implants are in place, the more difficult they might be to remove due to adhesions and scar tissue formation. In fact, it has been recommended that when the implants cannot be felt in the woman's arm, or they migrate to deeper tissues, x-ray or ultrasound be employed to help locate the Norplant rods.
At a 1993 conference on contraception a Planned Parenthood physician reported that insertion of Norplant rods is usually uncomplicated, but that some health care providers have expressed difficulty in removing them. An obstetrics and gynecology professor recommended use of a curved hemostat [clamp] to "vigorously break up" adhesions.
Settlement of Norplant Lawsuits
I think this news bit makes an interesting point against an argument that lawsuits drove the manufacturer away from Norplant. (Settling didn't exactly hurt AHP/Wyeth'bottom line/profitability as a company.)
Proposed Infobox for individual birth control method articles
Let's all work on reaching a consensus for a new infobox to be placed on each individual birth control method's article. I've created one to start with on the Wikipedia Proposed Infoboxes page, so go check it out and get involved in the process. MamaGeek (Talk/Contrib) 12:26, 14 June 2006 (UTC)
Weight gain parameter in infobox
I would like to treat this parameter the same on all the hormonal contraception articles. Please read my opinion and discuss this issue at Talk:Combined oral contraceptive pill#Weight parameter in infobox. LyrlTalk C 21:30, 20 August 2007 (UTC)
Hi everyone, I'm no expert at all in editing Wikipedia articles, I found 5 modifications that were only vandalism and tried to remove them, but I don't know if I was doing it correctly. Could please somebody take proper care of that? Thanks and I'm really really sorry if I made any mistakes. —Preceding unsigned comment added by 220.127.116.11 (talk) 07:30, 19 May 2010 (UTC)
Relationship between Norplant and Norplant II (Jadelle)
The article is not clear on the relationship between Norplant and Norplant II (Jadelle). It is unclear where "Norplant" is mentioned in the article if this refers to Norplant I only or Norplant 2 only or both.
New Zealand Funding approval
New Zealand government pharmaceutical funding body has agreed to subsidize Norplant II (Jadelle) in New Zealand. It is likely this will lead to widespread use.
Medical Notes section
The medical notes section says "Insertion by untrained doctors had higher rates of local scarring and resultant difficulties in removal". This is not surprising. What is meant by "untrained doctors"? Does this mean 3rd world doctors? does this mean doctors who are not trained as doctors? does this mean doctors who have not been specifically trained in Norplant I/II installation?
This looks a lot like non-specific fluff trying to reassure potential users that scarring and removal difficulties do not occur when a competent doctor administers the product. Without any reference or statistics this is getting close to saying scaring and removal difficulties occur only if the doctor administering the product is not competent. I will remove the note. —Preceding unsigned comment added by 18.104.22.168 (talk) 02:54, 26 July 2010 (UTC)
Third world countries
Norplant has been discontinued in the United States for good reason. So, why is it being dumped on poor and unsuspecting Third World women? If it is not good enough for US women, it should not be marketed anywhere. Aren't our sisters around the world experiencing the same problems, complications, and side effects, perhaps with less access to medical care?
This section is almost completely based on a single source by Dorothy Roberts. This section should be completely rewritten to summarize relevant work on the subject rather than the single source. VQuakr (talk) 09:09, 5 December 2013 (UTC)
- Didn't do any research, but rewrote to reduce emphasis on Roberts and remove some editorializing. Corrected two facts that seemed to be wrong: the philly.com editorial seems to be careful to not outright endorse incentives, and the Baltimore program seems not to have "enforced" the use of Norplant. Rolf H Nelson (talk) 04:38, 16 December 2013 (UTC)