Talk:Levonorgestrel-releasing implant

Effectiveness

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[33]) 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."[34]

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[35],[36],[37],[38] and proposed for women harmed by silicone gel breast implants.[39]

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.[40]

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.[41]

—Preceding unsigned comment added by Cindery (talk • contribs) (09:49, 28 July 2006)

Settlement of Norplant Lawsuits

http://www.smartmoney.com/bn/index.cfm?story=19990826060414

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. Lyrl^Talk _C 21:30, 20 August 2007 (UTC)

Vandalism

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 200.125.76.55 (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 118.90.123.21 (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?

108.101.22.188 (talk) 07:19, 31 July 2010 (UTC) JMS

how?

how long does this side effect take for norplant,if you thunk your pregant — Preceding unsigned comment added by 173.11.65.102 (talk) 19:38, 16 February 2012 (UTC)

Controversy section

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)

NPOVN

This article has mentioned here at the WP:NPOV noticeboard. OlYeller21^Talktome 05:45, 9 December 2013 (UTC)

Move to Jadelle

The following discussion is an archived discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review. No further edits should be made to this section.

The result of the move request was: not moved. Merges and splits are outside the scope of RM, but it's clear that there's no consensus to re-title this article at the moment. Jenks24 (talk) 11:41, 2 August 2014 (UTC)

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Norplant → Jadelle – Norplant is discontinued, and replaced with Jadelle, also called Norplant-2. However, when using the term Norplant it is unclear whether the discontinued Norplant or Norplant-2 is referred to. Therefore, I find it best to move this article to Jadelle. Relisted. Jenks24 (talk) 13:46, 25 July 2014 (UTC) Mikael Häggström (talk) 11:44, 17 July 2014 (UTC)

• Oppose from the rationale, it's clear that "Norplant" is the better title. If Jadelle is also called Norplant (Norplant-2), then this article should stay at "Norplant", because it doesn't only cover Jadelle, it also covers Norplant. If you want to split the article in two, then that's a different matter. -- 65.94.171.126 (talk) 05:12, 18 July 2014 (UTC)
• Move to generic term Contraceptive implant. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:22, 18 July 2014 (UTC)
  • Contraceptive implant (edit | talk | history | protect | delete | links | watch | logs | views) is a different article. -- 65.94.171.126 (talk) 09:29, 18 July 2014 (UTC)
    • Sure yes it is technically a merge. Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:05, 18 July 2014 (UTC)
      • Wouldn't veterinary implantable contraceptives be different from Norplant? [1] deslorelin-based etc (or the experimental ones for males ? [2]) -- 65.94.171.126 (talk) 11:32, 18 July 2014 (UTC)

THey can still all be dealt with on the same page though. Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:27, 25 July 2014 (UTC)

This page is rather large to merge it into a general topic article, and cover the general topic without being overly specific about Norplant(I/II) -- 65.94.171.126 (talk) 04:20, 26 July 2014 (UTC)

• Comment: The WP:COMMONNAME of this sort of implanted contraceptive is probably still Norplant. I'd be willing to bet that more people have heard of Norplant than have heard of Jadelle (myself included, prior to seeing this move request). —BarrelProof (talk) 12:04, 29 July 2014 (UTC)
• Split into two articles, Norplant and Jadelle (aka Norplant-2). These are different (similar) drug delivery systems. Oppose merge with Contraceptive implant. If consensus is that there is inadequate material for a stand-alone article at Jadelle, then WP:COMMONNAME governs and the article should stay where it is. VQuakr (talk) 03:37, 30 July 2014 (UTC)
• Oppose suggested move to branded name for Norplant II. Best thing is move to generic term Contraceptive implant and redirect Norplant and Jadelle there. Jytdog (talk) 11:52, 30 July 2014 (UTC)
  • Comment do you mean merge? Contraceptive implant (edit | talk | history | protect | delete | links | watch | logs | views) is a different article. -- 65.94.169.222 (talk) 04:21, 31 July 2014 (UTC)
    • yes. Jytdog (talk) 12:50, 1 August 2014 (UTC)

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The above discussion is preserved as an archive of a requested move. Please do not modify it. Subsequent comments should be made in a new section on this talk page or in a move review. No further edits should be made to this section.

Requested move 22 August 2015

The following is a closed discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review. No further edits should be made to this section.

The result of the move request was: moved. The consensus is that the proposed title more accurately reflects the scope of the article and also conforms with the subject-specific naming conventions. No prejudice against further discussion about whether a separate article should be split out for Norplant (brand). Jenks24 (talk) 07:23, 8 September 2015 (UTC)

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Norplant → Levonorgestrel implant – We have a number of brand names that refer to this product including "Norplant", "Jadelle", and "Norplant II". Medicinenet uses "levonorgesterl implant" as the generic name [3]. This review use the generic name aswell [4] and so does this WHO document [5]. Per WP:PHARMMOS we should use the International Nonproprietary Name Doc James (talk · contribs · email) 01:14, 22 August 2015 (UTC) Relisted. Jenks24 (talk) 14:05, 31 August 2015 (UTC)

Additionally Norplant has not being sold since 2000 so the name is sort of historical at this point [6]. Doc James (talk · contribs · email) 01:18, 22 August 2015 (UTC)

• Oppose rename for two reasons: this is a drug delivery device, not a drug, and WP:UCRN strongly favors "Norplant" in this case (the pharma naming guideline you link even references the common name policy as an exception). As per my response in the last move discussion I have no opposition to creation of a separate article about implanted contraceptives in general, but this specific, branded, obsolete product is independently notable. VQuakr (talk) 02:21, 22 August 2015 (UTC)

  Having a seperate article for each brand of an medical item is generally discouraged. Doc James (talk · contribs · email) 03:31, 22 August 2015 (UTC)

  There is already a separate article about the contraceptive implant concept. I notice that Norplant II is a redirect to Levonorgestrel. I hope we end up with some clear rational relationship between these articles. —BarrelProof (talk) 03:54, 22 August 2015 (UTC)

  Yes Norplant II should redirect to whatever this article is called. Have changed it Doc James (talk · contribs · email) 04:08, 22 August 2015 (UTC)

@Doc James: but this specific product is particularly notable. VQuakr (talk) 03:58, 22 August 2015 (UTC)

If we want an article about the brand we can have one but I do not think their is a enough for one. Look at Tylenol which redirects as it should to paracetamol. We than have a subarticle on Tylenol (brand) Doc James (talk · contribs · email) 04:09, 22 August 2015 (UTC)

• support we should useInternational Nonproprietary Name --Ozzie10aaaa (talk) 02:38, 22 August 2015 (UTC)

WP:NOTAVOTE. Why? VQuakr (talk) 03:58, 22 August 2015 (UTC)

because the World Health Organization, has used the generic name--Ozzie10aaaa (talk) 10:36, 22 August 2015 (UTC)

• Oppose move, but split into Norplant and Levonorgestrel implant articles (or possibly include a section on Levonorgestrel implants in contraceptive implant). It is highly non-neutral to have a non-proprietary name sold under many brands redirect to an article on one specific brand, but VQuakr is correct that Norplant is individually notable. Most information in this article appears specific to Norplant, so what little information exists about the more generic implant type should break off into a neutral article. The lead should be rewritten to be specifically about Norplant. ~ Rob^Talk 08:41, 22 August 2015 (UTC)
• Support move - we should always go with the generic name. There is very little medical content here that is specific to Norplant, and what is specific to Norplant is the just the start of the history of Levonorgestrel implants that has been carried forward by other specific products. Jytdog (talk) 02:45, 23 August 2015 (UTC)
• Support There should be an article at the generic name. It may be possible to split an article on the brand name. Plantdrew (talk) 07:24, 4 September 2015 (UTC)

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The above discussion is preserved as an archive of a requested move. Please do not modify it. Subsequent comments should be made in a new section on this talk page or in a move review. No further edits should be made to this section.

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