May Norplant increase depression risk?

 

What is Norplant?

 

Norplant is a form of birth control, specifically a contraceptive implant, consisting of consisted of a set of small, flexible rods that are implanted under the skin of a woman's upper arm. These rods slowly released the hormone levonorgestrel, which is a form of progestin. This hormone primarily works by preventing ovulation, thickening cervical mucus to inhibit sperm movement, and thinning the lining of the uterus to prevent implantation of a fertilized egg.

 

The Norplant contraceptive, approved by the Food and Drug Administration and marketed since 1992, is implanted just under the skin of the inner arm, right above the elbow. Developed by the Population Council of New York, this birth control alternative is distinctly different from methods previously available.

 

Effective within 24 hours after insertion, Norplant can continue to prevent pregnancy for up to five years. The hormone usually inhibits ovulation so that eggs are not produced regularly, and causes the mucus of the cervix to thicken, making it more difficult for sperm to reach the egg. Other ways that Norplant may provide contraceptive effects have been proposed but not proven.


 

Advantages

 

The advantages of contraceptive implants like Norplant, and its successors Nexplanon and Implanon, include:

1.       Effectiveness: Implants are one of the most effective forms of birth control available, with a failure rate of less than 1%. This high level of effectiveness is primarily due to the reduced risk of human error compared to other methods like pills, which must be taken daily.

2.       Long Duration: Once implanted, these devices can provide continuous contraception for up to three to five years, depending on the specific product. This long duration eliminates the need for daily, weekly, or monthly attention to contraception.

3.       Reversibility: Despite their long-acting nature, contraceptive implants are reversible. Once the implant is removed, fertility typically returns quickly, often within a few weeks.

4.       Convenience: Implants offer a "set it and forget it" approach to birth control, which can be particularly appealing for those who have difficulty remembering to take a pill every day or who have lifestyle constraints that make regular medical appointments challenging.

5.       Discretion: The implant is placed under the skin and is not visible from the outside, which can provide privacy for users who may not wish to disclose their use of birth control.

6.       Non-Estrogenic: Implants like Norplant and its successors use progestin without estrogen, which can be an important advantage for women who cannot use estrogen-containing birth control due to certain health conditions like cardiovascular risks, migraines, or a history of certain cancers.

7.       Menstrual Benefits: For some women, contraceptive implants can reduce menstrual bleeding and pain over time, and may also help in managing symptoms of conditions like endometriosis.

8.       Suitable for Many Women: Implants can be used by a wide range of women, including those who are breastfeeding, have just given birth, or for whom estrogen-containing contraceptives are contraindicated.

 

Side Effects

 

Contraceptive implants like Norplant, Nexplanon, and Implanon are generally safe, but they can cause side effects in some users. The side effects can vary from minor to more significant, and not all users will experience them. Here are some common and less common side effects associated with contraceptive implants:

Common Side Effects

·         Changes in Menstrual Patterns: Many users experience irregular bleeding, lighter periods, or may stop having periods altogether. Some women may have longer or heavier periods, especially in the first few months after insertion.

·         Mood Changes: Some users report mood swings or changes, which can include depression or anxiety.

·         Weight Gain: While the research is mixed, some users report weight gain after getting a contraceptive implant.

·         Headaches: Some women may experience headaches, which can vary in frequency and intensity.

·         Acne: Hormonal changes caused by the implant can lead to acne in some users.

·         Breast Tenderness: Some women may experience breast tenderness or pain shortly after the implant is placed.

Less Common Side Effects

·         Infection at the Insertion Site: There is a small risk of infection at the site where the implant is inserted.

·         Implant Migration: Very rarely, an implant can move from its original placement site, which might make removal more difficult.

·         Ovarian Cysts: Some users may develop ovarian cysts, which usually resolve on their own but can cause discomfort if they become large or rupture.

·         Nausea: Some women might experience nausea after implant insertion, although this is typically temporary.

·         Hair Changes: Some users report hair loss or increased hair growth on the body.

Serious Side Effects

While rare, serious side effects can occur, such as:

·         Blood Clots: Hormonal contraceptives can increase the risk of blood clots, although the risk is generally lower with progestin-only methods like implants compared to those that also contain estrogen.

 

May it cause depression?

 

The respectable study in Denmark in 2000 – 2013 found small but distinctive correlation between the Norplant use and depression, especially in young adults. The progesterone content of oral contraceptives has been positively linked to major depression and panic disorder. Since Norplant is a progestin-only preparation, it is likely that some women will develop these disorders.

 

Yes, contraceptive implants can potentially cause mood changes, including symptoms of depression. While not everyone who uses a contraceptive implant will experience mood-related side effects, some women do report feeling depressed after having an implant inserted. The relationship between hormonal contraception and mood changes, including depression, has been the subject of considerable research and debate.

 

The hormones released by contraceptive implants, such as progestin (a synthetic form of progesterone), can affect brain chemistry, which in turn can influence mood. These effects may vary widely among different individuals due to variations in hormone sensitivity, personal and family mental health history, and other physiological factors.

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