How the contraceptive implant works

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Everything you need to know about the contraceptive implant, a method of birth control which can prevent pregnancy for up to three years.

By Dr Juliet McGrattan (MBChB)

When it comes to contraceptives, there are so many options to choose from it can become confusing. What is right for you will vary at different times of your life. The contraceptive implant is just one of the potential routes you can go down. If you’re looking for a very reliable, long term contraceptive then it could be perfect for you. Here’s everything you need to know about he contraceptive implant:

What is the contraceptive implant?

The implant is a long-acting reversible contraception (LARC) that offers reliable contraceptive cover without the need for remembering to take tablets. LARCs are known as ‘fit and forget’ methods, which means once they are fitted, women are protected from getting pregnant until they need replacing.

The contraceptive implant is a small waxy rod approximately the same size as a matchstick. It sits just under the skin in the upper arm. It contains progestogen, which is released into the blood stream steadily over a period of three years.

How does the contraceptive implant work?

The implant works by steadily releasing progestogen (which mimics our natural female hormone progesterone) into the blood stream.

The progestogen has several effects that make conception and implantation of a pregnancy unlikely: most importantly it prevents ovulation (the release of an egg from the ovary), but also it thickens mucus around the cervix making it more difficult for sperm to get through.

It also thins the lining of the womb making the environment unfavourable for a pregnancy to implant and begin to develop.

💡 The contraceptive implant is 99 per cent effective and has the lowest failure rate of all methods, which means it is considered to be the most reliable, as the least number of women get pregnant while using it.

How is the implant fitted and removed?

The contraceptive implant requires a small procedure to be fitted.

Speak to your doctor or nurse or family planning doctor who is fitting the implant in the preliminary appointment to make sure you understand rules for contraception or abstaining from sex in the time leading up to the fitting to avoid unwanted pregnancy.

There will be strict instructions from the doctor to follow beforehand as it is very important that there is no risk of you being pregnant when the implant is fitted or conceiving just as it is fitted. You will usually be advised to not have sex from the first day of your last period and to not have unprotected sex in the three weeks before the fitting.

If the implant is fitted following these rules during the first five days of the menstrual cycle you will be immediately protected against becoming pregnant. If it is fitted on any other day you will need to use additional contraception such as condoms for 7 days. There will be specific instructions if you are changing from another form of contraception or soon after a pregnancy, hence you will have an appointment to discuss all of this before the actual fitting appointment.

First, a local anaesthetic is used to numb the inside of your upper arm. Then an applicator is used to insert the implant just under the inside of your skin. You’ll wear a plaster and a small bandage for a few days, but no stitches are required.

Having a contraceptive implant fitted is not painful. There will be a short pricking feeling from the needle used to inject the local anaesthetic. After that you will feel the doctor or nurse pushing on your arm as they insert the implant but it won’t be painful.

The contraceptive implant can be taken out at any point during the three years. To remove the implant, a local anaesthetic will be used to numb the area, then a small cut is made in the skin so that the implant can be gently pulled out.

The contraceptive implant benefits

The contraceptive implant comes with the following benefits:

️ The contraceptive implant is easy

The contraceptive implant is a ‘fit and forget’ method of contraception. It does the job all by itself with no need for tablets to be taken.

️ The contraceptive implant works long term

Once fitted, the contraceptive implant works for up to three years.

️ It is a good option if you can’t use other contraceptives

The contraceptive implant can be used in women who are breastfeeding, or who have medical conditions that prevent them from being able to use contraceptives that contain oestrogen, such as migraines with aura or some blood clotting disorders.

️ The contraceptive implant helps reduce period pain

If you suffer from cramps with your monthly bleed then you may benefit from using the implant.

️ The contraceptive implant works

The implant is more than 99 per cent effective. Unlike the contraceptive pill, it’s not affected by sickness or diarrhoea.

️ The contraceptive implant reverses quickly

If you decide you want to try to get pregnant then the contraceptive implant can be removed and your fertility will return quickly.

The contraceptive implant side-effects

The implant can come with side-effects. However, they are usually minimal. These are all symptoms that are not specific to the implant and may occur with any hormonal treatment. Generally, the implant is well tolerated and liked.

Potential implant side-effects can include:

  • Irregular bleeding
  • Feeling emotional, tearful or low
  • Skin breakouts
  • Breast tenderness

Weight gain and headaches are two symptoms that some women report after using the implant but there’s no evidence from medical studies that the implant causes them.

If you experience any extreme side effects or have any concerns, speak to your GP.

Who can use a contraceptive implant?

There are very few women for whom the implant is not recommended. In fact, the implant is a good option in situations where other contraceptives can’t be used.

  1. There is no upper age limit for the implant.
  2. Women who are pregnant or can’t exclude being pregnant should not have the implant inserted.
  3. Women who have undiagnosed vaginal bleeding such as bleeding after sex or between periods should not have the implant inserted until the cause has been established.
  4. Women who take enzyme-inducing medications including some anti-epileptic drugs, antibiotics and anti-virals should use a different method of contraception because the implant may not be effective. St John’s wort is an enzyme inducing complementary medication so should not be taken with the implant.
  5. Women who are obese may be offered a change of implant earlier than three years. There is no clear evidence that the dose of progestogen in the implant will be insufficient for a high body weight but it is an option for doctors to consider.

Can you feel the implant?

Before a doctor or nurse fits an implant they undergo special training. The implant sits just underneath the skin and you should be able to feel it if you run your fingertips over the area.

If you are unable to feel it or you think it has changed shape, become painful or you notice changes of the skin overlying the implant, then you should make an appointment with your doctor. If you can’t feel the implant, use another method of contraception such as a condom while you are waiting for the appointment. If the doctor or nurse is unable to feel it they may arrange for an ultrasound scan to check the position.

Do you need a check up after the implant is fitted?

The implant really is a ‘fit and forget’ method of contraception. Once it is inserted there is no need for any follow up appointment with your doctor. You can of course go back at any point if you have any problems or concerns about your implant.

You must have your implant removed and another inserted at the right time otherwise you may be at risk of pregnancy.

Remember that a contraceptive implant will not protect you against sexually transmitted infections. You should use a condom to protect you against these.

Net Doctor

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