New methods in hormonal contraception [Hormonal kontrasepsiyonda yeni yontemler]

Long-acting hormonal contraceptive methods have long been discussed in contraception. There are many different systems related with it, in this review we consider mainly the subdermal implants. The levonorgestrel implant (Norplant) consists of six rods, each measuring 34 mm. in length and 2.4 mm in outside diameter and containing 36 mg of the progestin levonorgestrel. Approximately 80 µg/day is released during the first 6-12 months after insertion. The release rate then gradually declines to 30-35 µg/day. Blood levels of the steroid remain above 0.25 ng/ml for 5 years. Progestin blocks ovulation, cervical mucus becomes scant and thick and does not allow sperm penetration. The implant produces endometrial atrophy. Irregular bleeding and headache are the main reasons given for discontinuing use of implants. Side effects that are occasionally reported include acne, weight gain or loss, mastalgia, mood change, depression, hirsutism and galactorrhea