What is the contraceptive implant?
The contraceptive implant is a small flexible plastic rod which is placed under your skin. It slowly releases the progesterone hormone and gives contraceptive protection for three years. The implant is usually inserted in the inner part of the upper arm and while it can be felt under the skin it cannot be seen. There is only one implant available in Ireland at this time – Implanon.
How does it work?
How safe is it?
The implant is an extremely effective method of contraception. The pregnancy rate associated with the use of Implanon is very low. Less than 1 in 1000 women using it over three years will become pregnant. However some prescribed medicines may make an implant less effective so always inform your doctor if you are being prescribed medicines.
Where can I get the implant?
How is the implant inserted?
You will get a local anaesthetic to numb the part of your arm where the implant will go so it does not hurt to have it put in. it is similar to having an injection. Stitches will not be necessary. The area may be tender and bruised afterwards. The doctor or nurse will put a dressing on it to keep it clean and dry, this should be left on for a few days. You will be able to feel for the implant under the skin but will not be aware of it otherwise. It is not usually visible. If you have any problems, particularly pain, swelling or redness at the implant site, heavy or persistent bleeding or migraine, you should contact your nurse or doctor.
How is the implant removed?
You will receive a local anaesthetic to numb the skin over the implant first. It usually takes a few minutes to remove an implant. If the implant has been put in correctly, it should not be difficult to remove. The doctor or nurse will feel for the implant under the skin, make a tiny cut and gently pull the implant out. Occasionally an implant is difficult to feel under the skin and it may not be so easy to remove. If this happens you may be referred to a specialist centre to have it removed with the help of an ultrasound scan.
What if I want to stop using the implant before three years are up?
You don’t have to keep an implant in for three years. If you decide you want to stop using it, see your doctor and ask to have it removed. You will stop being protected against pregnancy immediately after the implant is removed. An implant is designed to be used for three years and is not a short-term method of contraception. If you are not sure you want contraceptive protection for this long, other methods of contraception may be more suitable for you. There is no evidence that there is a delay in return to fertility after the removal of an implant. Over 90% of women will have returned to a normal cycle within 4 – 6 weeks.
Are there any side effects?
- Your periods will probably change. In the first 3 – 6 months of use, many women have irregular bleeding. After this most women will have lighter and/ or less frequent periods. Some will have regular monthly periods and some will not bleed at all. These changes are not harmful. However consult your doctor if you are unhappy with your bleeding pattern.
- May be associated with acne.
- Removal may leave a small scar.
- Although research has not shown implants to cause depression or mood changes, some women may experience these symptoms.
- No protection against sexually transmitted infections, so you may also need to use a condom.
- Very rarely an infection or allergic reaction could occur.
- There is no evidence that the Implanon is associated with weight gain.
How soon does the implant work?
Can I get a new implant once the three years is finished?
Yes, if there are no medical problems you can continue to use the implant until you reach the menopause. Each implant will have to be changed every 3 years. There is no limit to the number of implants you can have fitted.
Does other medication affect the implant?
The implant is not affected by the use of common antibiotics, but is affected by enzyme-inducing medication such as HIV treatments or epilepsy medication. As with many medications, tell your doctor if you are using hormonal contraception. The complementary medicine St John’s Wort may also make the contraceptive less effective.
Can anyone have an implant?
Not everyone can have an implant and your doctor or nurse will need to ask you about your family’s medical history. Some conditions which mean you should not have an implant are:
- You think you may already be pregnant.
- You do not want your periods to change.
- A number of past or present medical conditions may also mean that an implant would not be your first choice of contraceptive.
What if I become pregnant?
The implant is a highly effective method of contraception; it is unlikely that you are pregnant. If you do get pregnant while you are using the implant there is no evidence that it will harm the baby.
You can have an implant put in 3 weeks (21 days) after you have given birth. If the implant is put in on or before day 21 you will be protected from pregnancy immediately. If the implant is put in later than day 21 you will need to use an extra method of contraception for 7 days. An implant can be used safely while you are breastfeeding and will not affect your milk supply.
After an abortion or miscarriage
The implant can be used immediately after a miscarriage or abortion. You will be protected against pregnancy immediately.