الفهرس | Only 14 pages are availabe for public view |
Abstract Norplant implant system 1s becoming widely used contraception as a long term reversible progestogen only contraception system (Singh and Ratnam, 1997). This system consists of 6 silastic capsules containing levonorgestrel which is the active isomer of the norgestrel, one of the members of the family 19 nortestosterone which has residual androgenic activity (Speroff et al., 1999). Because of its androgenic activity and also the potent antiestrogenic activity as it is expected to lower HDL cholesterol (Fotherbay, 1984). Recent studies shows that total triglycerides (TG), cholesterol and low density lipoprotein cholesterol (LDL-c) were decreased through five years of Norplant use. High density lipoprotein cholesterol (HDL-c) showed a significant increase in the first year followed by decrease over the years to its preinsertion level (Singh et al., 1989, 1992), Other studies show that total serum TG and cholesterol were reduced during the use ofNorplant while HDL cholesterol was significantly reduced following six months of Norplant use. At twelve months, the value improved but it was sill significantly decreased when compared to preinsertion value (Otubu et al., 1993). Singh et al. (1993) have reported that total cholesterol, LDL cholesterol and total TG continued to remain below the preinsertion mean at six months post removal but HDL cholesterol showed a significant increase following removal of Norplant. The strong inverse relation between HDL-c concentration and coronary heart disease (CHD) risk is well established by observational epidemiologic studies. Each 1-mg/dL increment in HDL-c is associated with a 2% risk decrement in men and 3% risk decrement in women of CHD (Ass mann et al., 1998). |