Local reactions at the insertion site of the Norplant® contraceptive system

The Norplant® contraceptive system is a new system that provides a steady-state level of levonorgestrel for 5 years. Because this system has six flexible polymethylsiloxane capsules that must be implanted subdermally in the medial upper arm, insertion of the system has been associated with local reactions. Infection and expulsion of the capsules is the most common complication occurring in less than 1% of patients. Skin reactions to the implant include the formation of blisters, scabs, pain and itching, and soreness at the implant site. Injury to a superficial nerve is the most rare complication. Technical considerations in the insertion and removal of the capsules that may reduce the frequency of these local reactions are reported.