Contraception information – implant

Implant

Benefits

Works for three years
You don’t have to prepare for or interrupt sex
You don’t have to remember to take a pill everyday
You don’t need a vaginal examination
May reduce heavy or painful periods after first year
Suitable for those that can’t take oestrogen
Fertility returns to normal when removed
May also give some protection against cancer of the womb.

The implant is a small, flexible plastic tube that sits under the skin of your upper arm and releases the progestogen hormone. It is long-acting and reversible, so you can take it out if you want to get pregnant.

It is the fourth most popular method of contraception in the UK, and more common amongst women under the age of 35.

How it works

How to use it

A clinician will insert the implant under the skin of your upper arm.

Once the implant is in place, you don't have to think about contraception. It won't interrupt sex and you won’t see it. In the UK, Nexplanon is the main contraceptive implant currently in use. It is 4cm long – the size of a matchstick.

It can be removed at any time by a trained doctor or nurse. It only takes a few minutes to remove, using a local anaesthetic.

Why it works

The hormones released by the implant prevent pregnancy by:

Preventing the ovaries from releasing an egg each month (ovulation)
Thickening the mucus in the neck of the womb, so it is harder for sperm to penetrate the womb and reach an egg
Thinning the lining of the womb, so there is less chance of a fertilised egg implanting into the womb.'

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Things to consider

The implant does not protect you from STIs. You should use a condom as well if you think you are at risk of an STI.

A small procedure is required to fit and remove the implant, this only takes a few minutes, using a local anaesthetic.

The implant can change your periods significantly. This varies from woman to woman – you may have no bleeding at all, or more prolonged, more infrequent or irregular bleeding. This is not harmful but may be inconvenient.

Suitability

Most women can use the implant, but your clinician will ask about your family and medical history to determine whether or not the implant is the best method for you.

The implant is not suitable for women who:

Are pregnant
Have unexplained irregular bleeding
Want regular periods
Take certain medicines.

It also may not be suitable for women who have or have had certain health conditions.

Side effects & risks

	Common	Rare
Short term:	Spotty skin, breast tenderness, nausea, headaches, loss of sex drive, changes in mood.	The area of skin where the implant has been fitted can become infected. The skin will be cleaned and may be treated with antibiotics.
Long term:	Periods may change significantly: bleeding may be prolonged or infrequent, or you will have no bleeding.

If short term symptoms do not go after a few months, or if you have prolonged or severe headaches, you should talk to your sexual health clinic or GP.

Questions?

What is local anaesthetic?

Local anaesthetic causes a complete loss of pain sensation to a specific area of your body without making you lose consciousness.

It works by blocking the nerves from the affected part of your body so that signals can't reach your brain. You will not be able to feel any pain during the procedure but you may still feel some pressure or movement.

It only takes a few minutes to lose feeling in the area where local anaesthetic is given. Your doctor will make sure the area is fully numb before starting the procedure.

It can take a few hours for local anaesthetic to wear off and for full feeling to return. You should be careful not to damage the area during this time.

How quickly will the implant start to work?

If the implant is fitted during the first five days of your menstrual cycle, you will be immediately protected against becoming pregnant. If it is fitted on any other day of your menstrual cycle, you will not be protected against pregnancy for up to seven days, and should use another method, such as condoms.

Does the implant affect my fertility?

Your fertility should return to normal as soon as the implant is removed.

Can medicines affect how the implant works?

Some medicines make the implant less effective (including those used to treat epilepsy, HIV and TB, and the herbal medicine St John’s Wort). Ask your GP, clinician or pharmacist and read the information that comes with your medicine.

Always tell your doctor that you have an implant if you are prescribed any medicines.

Does it hurt to get the implant fitted?

A local anaesthetic is used to numb the area so it won’t hurt.

The small wound made in your arm is closed with a dressing and does not need stitches. There may be some bruising, tenderness and swelling for a couple of days afterwards.

Will other people be able to see my implant?

No. But there may be some visible bruising for a couple of days after having the implant fitted.

Could the implant get lost in my body or snap?

When correctly inserted, the implant lies in the tissue just below the surface of the skin. This holds it in position and it should not get lost. Because the implant is made of a flexible plastic, it is unlikely to break inside the user’s arm.

Can I use the implant after having a baby?

Yes, the implant can be fitted after having a baby.

Can I use the implant while breastfeeding?

An implant can be used safely while you are breastfeeding and will not affect your milk supply.

I’ve had a serious health condition. Can I use the implant?

You may not be able to use the implant if you have or have had any of the following:

Severe heart disease
Migraines
Breast cancer
Disease or tumours in the liver
Unexplained vaginal bleeding
Systemic lupus erythematosus.

Speak to your GP about whether it is suitable for you.

What if I leave the implant in for more than three years?

Implants will no longer be effective after three years and they should be removed at this point. However, they will not cause any immediate harm if left place longer than three years.

Can I use the implant if I’m approaching menopause?

If you're 45 or older when you have the implant fitted, it can be left until you reach menopause or you no longer need contraception.

Why does the implant affect my periods?

The hormone progesterone in the implant has important contraceptive effects but also is associated with irregular bleeding.

What if I want to have the implant removed?

You can have the implant removed at any time.

Where can I get it?

The implant is free on the NHS. It can be fitted by most sexual health clinics and some GPs. Talk to your clinician about whether it’s right for you. Your clinician will be able to tell you where you can get it fitted nearby, if they can’t do it themselves.

The implant can be fitted at any time during your monthly menstrual cycle, as long as you're definitely not pregnant.