implant

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4 years ago

https://www.nhs.uk/conditions/contraception/contraceptive-implant/

The contraceptive implant (Nexplanon) is a small flexible plastic rod that's placed under the skin in your upper arm by a doctor or nurse.

It releases the hormone progestogen into your bloodstream to prevent pregnancy and lasts for 3 years.

At a glance: the implant

The implant is more than 99% effective.
Once the implant is in place, you don't have to think about it again for 3 years.
It can be useful for women who can't use contraception that contains oestrogen.
It's very useful for women who find it difficult to remember to take a pill at the same time every day.
The implant can be taken out if you have side effects.
You can have it removed at any time, and your natural fertility will return very quickly.
When it's first put in, you may feel some bruising, tenderness or swelling around the implant.
Your periods may become irregular, lighter, heavier or longer.
A common side effect is that your periods stop (amenorrhoea). It's not harmful, but you may want to consider this before deciding to have an implant.
Some medicines can make the implant less effective.
It doesn't protect against sexually transmitted infections (STIs), so you may need to use condoms as well.

How it works

The implant steadily releases the hormone progestogen into your bloodstream, which prevents the release of an egg each month (ovulation).

It also thickens the cervical mucus, which makes it more difficult for sperm to move through the cervix, and thins the lining of the womb so a fertilised egg is less likely to implant itself.

When it starts to work

You can have the implant put in at any time during your menstrual cycle, as long as you're not pregnant.

If the implant is fitted during the first 5 days of your menstrual cycle, you'll be immediately protected against becoming pregnant.

If it's fitted on any other day of your menstrual cycle, you'll need to use additional contraception (such as condoms) for 7 days.

After giving birth

You can have the implant fitted any time after you've given birth.

If it's fitted before day 21 after the birth, you'll be immediately protected against becoming pregnant.

If it's fitted on or after day 21, you'll need to use additional contraception (such as condoms) for the next 7 days.

It's safe to use the implant while you're breastfeeding.

After a miscarriage or abortion

The implant can be fitted immediately after a miscarriage or an abortion and you'll be protected against pregnancy straight away.

How is a contraceptive implant fitted or removed?

A local anaesthetic is used to numb the area on the inside of your upper arm.

The implant is then inserted under your skin – it only takes a few minutes to put in and feels like having an injection. You won’t need any stitches after your implant has been fitted.

Nexplanon works for 3 years before it needs to be replaced. You can use this method until you reach the menopause, when a woman's monthly periods stop naturally.

The implant can be removed at any time by a specially trained doctor or nurse. It only takes a few minutes to remove, and a local anaesthetic will be used. The doctor or nurse will make a tiny cut in your skin to gently pull the implant out.

As soon as the implant has been removed, you'll no longer be protected against pregnancy.

Who can use the implant

Most women can be fitted with the contraceptive implant.

It may not be suitable if you:

think you might be pregnant
don't want your periods to change
take other medicines that may affect the implant
have unexplained bleeding in between periods or after sex
have arterial disease or a history of heart disease or stroke
have liver disease
have breast cancer or have had it in the past
have a medical condition that may affect which contraception you can use – speak to your GP or practice nurse, or visit your nearest sexual health clinic to discuss further

Advantages and disadvantages of the implant

Advantages:

it works for 3 years
it doesn't interrupt sex
it's an option if you can't use oestrogen-based contraception, such as the combined contraceptive pill, contraceptive patch or vaginal ring
it's safe to use while you're breastfeeding
your fertility will return to normal as soon as the implant is taken out
it may reduce heavy periods or painful periods

Disadvantages:

you may experience temporary side effects during the first few months, like headaches, nausea, breast tenderness and mood swings
your periods may be irregular or stop altogether
you may get acne or your acne might get worse
you'll need a small procedure to have it fitted and removed
it doesn't protect you against sexually transmitted infections (STIs), so you may need to use additional contraception (such as condoms) as well

Will other medicines affect the implant?

Some medicines can make the implant less effective, such as:

medicines for HIV, epilepsy and tuberculosis
complementary remedies, such as St John's Wort
some antibiotics, such as rifabutin or rifampicin

If you're taking any of these medicines, you'll need additional contraception (such as condoms), or you may wish to use a different method of contraception that isn't affected by your medicine.

Always tell your doctor that you're using an implant if you're prescribed any medicine. You can also ask them whether the medicine you're taking will affect the implant.