What Is The Contraceptive Implant?

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Contraceptive implants are a popular and effective long-term birth control method. They are also called long-acting reversible contraception (LARC) and are effective for up to 3 years. Nexplanon is a commonly used brand in the United Kingdom. Perhaps the greatest benefit of the implant is that it gives women the freedom of not having to worry about taking their contraceptives on time.

A contraceptive implant is a flexible plastic rod about 4cm in length that is placed under the skin of your non-dominant upper arm. The implant releases a low, steady dose of the hormone progestin. It is oestrogen-free which lowers the risk of blood clots forming.

Progestin prevents pregnancy by blocking ovulation. It thickens the mucus of the cervix which makes it harder for sperm to reach an egg. Progestin also thins the lining of the uterus which makes it harder for the fertilised egg to attach to the uterus if conception takes place.

Inserting And Removing The Implant

The implant can be inserted at any time during your menstrual cycle if you are not pregnant. If the implant is inserted during the first 5 days of your menstrual cycle, you will be immediately protected against becoming pregnant. If it is fitted afterwards, you will not be protected against pregnancy for up to 7 days.

You can have the implant fitted 3 weeks after you have given birth. It is safe to have an implant fitted while you are breastfeeding. You can have the implant fitted immediately after a miscarriage or an abortion and will be protected against pregnancy immediately.

Before inserting the implant, your healthcare provider will apply a local anaesthetic to numb the area of insertion on your upper arm. The small wound made in your arm is closed with a dressing and does not need stitches. When it is first inserted, you may feel some bruising, tenderness or swelling around the implant.

In the first year after the implant is inserted, your periods may become irregular, lighter, heavier, or longer. This is nothing to worry about and will usually settle down after a few months. There is no evidence to show that you will gain weight with the implant.

The implant can be removed at any time by a specially trained doctor or nurse. It is a quick and nearly painless procedure that only takes a few minutes to remove. Once the implant is removed your natural fertility will return and you will no longer be protected against pregnancy.

Who Should Not Use Contraceptive Implants?

While contraceptive implants offer great convenience, they may not be suitable for everyone. If you have specific conditions or circumstances, your healthcare provider may recommend alternative birth control methods. These include having allergies to any components of the implant, a previous history of serious blood clots, heart attack or stroke, liver tumours or disease, a history of breast cancer, or experiencing irregular menstrual bleeding (bleeding outside of your regular period).

It is important to consult with your healthcare provider to determine the most appropriate birth control option for you.

You should advise your healthcare provider if you have a history of allergies, depression, diabetes, gallbladder disease, high blood pressure, high cholesterol, seizures, or epilepsy.

Certain medicines and herbal products can decrease the efficacy of the implant by lowering the levels of progestin in your blood. Medicines known to have this effect include certain seizure medicines, sedatives, HIV medicines and St. John's wort.

What Are The Benefits Of Having The Implant?

The convenience and efficacy of the contraceptive implant can greatly improve a woman’s quality of life. Benefits of having the implant include:

  • Contraceptive implants are highly effective (over 99%). Less than 1 woman in 1,000 who has had the implant for 3 years will get pregnant.
  • The implants last for 3 years which are far more convenient than conventional contraceptive tablets. It is very useful for women who struggle to take a pill at the same time every day.
  • Once the implant is fitted, you do not have to think about contraception for 3 years.
  • The implant is reversible, and your healthcare provider can remove it at any time if you are having side effects or wish to get pregnant.
  • Your natural fertility returns very quickly after the implant is removed.
  • Implants are a good option for women who cannot use contraception that contains oestrogen.

What Are The Risks Of Having An Implant?

Although implants are a revolutionary addition to family planning and a highly effective contraceptive, there are a few known disadvantages of having the implant, including:

  • Some medications, such as seizure medicines, sedatives, HIV medicines and certain antibiotics, can make the implant less effective. You should use extra contraception when taking these medications.
  • Your menstrual cycle (bleeding patterns) may change significantly while using a contraceptive implant. Around 20% of women will have no bleeding, while almost 50% will have infrequent or prolonged bleeding.
  • The implant does not protect against sexually transmitted infections (STIs). You will need to use condoms to protect yourself against STIs.
  • Some women complain of troublesome side effects such as headaches, acne, nausea, breast tenderness and loss of sex drive (libido). These side effects usually stop after the first few months.
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