Contraceptive Implants

The contraceptive implant is a long-term birth control device that’s placed under the skin in your upper arm by a nurse or doctor. It’s a small plastic rod, 4 cm long and 0.2cm wide – that’s about the size of a matchstick).

The contraceptive implant contains a man-made progestogen hormone. The implant is placed under your upper arm skin, where it slowly releases the hormone for up to 3 years (unless you decide to remove it sooner than that).

The birth control implant steadily releases the progestogen hormone into your blood, making it very unlikely you will get pregnant. It mainly does this in 3 ways:

• By thickening the mucus in your cervix, making it very difficult for sperm to move through your cervix to reach your fallopian tubes and ovaries
• By preventing the release of an egg every month (ovulation)
• By making the lining of your womb thinner so even if one of your eggs is fertilised, it would not be able to attach to the womb

The implant doesn’t protect you from getting sexually transmitted infections (STIs) so you should also use a condom if you need protection.

About 1 in 3000 women who are sexually active may become pregnant using the contraceptive implant, each year. This is compared to 4 out of 5 sexually active women who get pregnant each year if they don't use any contraception.

Like many types of contraception the contraceptive implant is over 99% effective with ‘perfect use’ (when used according to the correct instructions). The implant may be less effective with ‘actual use’ (when the correct usage instructions are not always followed).

For instance, some women using the implant end up pregnant, often because they were already pregnant when they got the implant and didn’t know. Also it can be because they didn’t use a condom for the first 7 days after getting the contraceptive implant.

The implant can also be very convenient. If you get the contraceptive implant, you don’t have to do anything else with it until you’re ready to remove it. The contraceptive pill for example, has to be taken daily.

The contraceptive implant has received mixed reviews since its initial introduction as a contraceptive option:

• Some women have had no major side effects and have continued to use the implant for the full 3 years
• Some women had a few side effects that they were willing to manage in exchange for the convenience of the birth control implant
• Other women had reported serious side effects or became pregnant and had to remove the implant before the 3 years had ended

In the UK, the contraceptive implant was changed from Implanon to a new product called Nexplanon after complaints about how the old implanon was inserted in the arm. Consumers were having problems with pain or numbness, and not being able to find the implant in their arms when it came time to remove it later.

Both the Implanon and Nexplanon contain the same type and amount of progesterone hormone (68 micrograms of etonogestrel).

They can both be used for up to 3 years and are removed in the same way.

But the Nexplanon is different from the Implanon in two ways:

• Nexplanon contains a chemical called barium which makes it easy to see on an X-ray or CT scan. For example, if it gets lost or has moved from its starting position
• Because of its new applicator, the Nexplanon is easier to insert into your arm, and has fewer risks of errors during the procedure

In the UK, you can get the contraceptive implant for free from GP surgeries, contraception clinics, or sexual health clinics.

You’ll need to contact them first to find out if they have doctors or nurses who are trained to insert the contraceptive implant.

Before you get the implant at the clinic, you may also need to do a pregnancy test.

During the procedure, a local anaesthetic will be used to numb the part of your upper arm skin where the implant will be inserted. The whole procedure takes less than 15 minutes and you won’t need any stitches afterwards.

Depending on when the first day of your last period was, and/or if you’re sexually active, you should also use a condom for the first 7 days after you get the contraceptive implant.

Although most women can get the contraceptive implant, it may not be suitable for you if you:

• think you might be pregnant
• don’t want your periods to change. They may become irregular or stop completely with the implant in
• have any heart disease or issues with thrombosis
• have liver disease
• have or have had breast cancer
• are taking certain medications that may affect how the implant works

The contraceptive implant can be removed at GP surgeries, contraceptive clinics, or sexual health clinics.

The implant can be removed at any time by a trained doctor or nurse. They would use a local anaesthetic and make a tiny cut in your skin to pull the implant out of your upper arm. It only takes a few minutes.

You’ll no longer be protected against pregnancy immediately after the contraceptive implant is removed.

The side effects you may have using the contraceptive implant include:

• headaches, breast tenderness, nausea, and mood swings in the first few months
• acne
• irregular periods or no periods altogether
• lower sex drive
• weight gain weight or weight loss
• stomach pains
• back pain

There’s a small risk of getting an infection at the place where the implant is put in and removed.

It’s also important to remember that you won’t be protected against STIs unless you use another form of contraception, like a condom, at the same time.