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Contraceptive implant

What is a contraceptive implant?

An implant is a small flexible rod that is placed just under your skin in your upper arm. It releases a progestogen hormone similar to the natural progesterone that women produce in their ovaries. It is a very effective, long-term hormonal method of contraception which protects you from pregnancy for up to 3 years. The implant that is available in the UK is called Implanon.

How effective is an implant?

How effective any contraceptive is depends on how old you are, how often you have sex and whether you follow the instructions.

If 100 sexually active women don’t use any contraception, 80 to 90 will become pregnant in a year.

If you follow the instructions, implants are over 99% effective. This means that less than 1 woman in 100 who use an implant will get pregnant in a year.

How does an implant work?

The main way it works is to stop your ovaries releasing an egg each month (ovulation). It also:

  • Thickens the mucus from your cervix. This makes it difficult for sperm to move through your cervix and reach an egg.

  • Makes the lining of your womb thinner so it is less likely to accept a fertilised egg.

Where can I get an implant?

Only a doctor or nurse who has been trained to fit implants can insert the implant. You can go to a family planning clinic or to the doctor or nurse at your general practice. If you prefer not to go to your own general practice, or they don’t provide contraceptive services, they can give you information about another practice or clinic. All treatment is free and confidential (see How do I find out about contraception services?)

Can anyone use an implant?

Most women who want to use an implant can have one fitted. The doctor or nurse will need to ask you about your own and your family’s medical history to make sure that the implant is suitable. You should tell them about any illnesses or operations you have had. An implant may not be suitable for you if:

  • you think you might already be pregnant

  •  you do not want your periods to change

  • you take certain medicines.

You have now, or have had in the past:

  • breast cancer

  • unexplained vaginal bleeding (for example, bleeding between periods or after sex)

  • thrombosis (blood clots) in any vein

  • a heart attack or stroke (serious arterial disease)

  • active liver disease.

How long is an implant effective for?

An implant is designed to be used for 3 years and is a long-term method of contraception. If you are not sure you want contraceptive protection for this long, other methods may be more suitable for you.

What are the advantages of an implant?

  • You don’t have to think about contraception for as long as the implant lasts

  •  It does not interrupt sex

  • You can use it if you are breastfeeding

  • It is a good method if you cannot use estrogens (hormones), like those in the combined pill

  • Your normal level of fertility will return as soon as the implant is taken out

  • It offers some protection against pelvic inflammatory disease

  • It may give you some protection against cancer of the womb

  • It may reduce heavy, painful periods

What are the disadvantages of an implant?

  • Your periods may change in a way that is not acceptable to you (see How will an implant affect my periods?

  • Other possible side-effects include headaches, spotty skin, putting on weight, tender breasts, bloating, and changes in mood and sex drive.

  • It requires a small procedure to insert and remove it (see How is an implant put in? and How is an implant taken out?)

  • An implant does not protect you against sexually transmitted infections, so you may need to use condoms as well.

Are there any risks?

  • Very rarely, soon after the implant is put in it can cause an infection in your arm, where it has been inserted

  • Research about the risk of breast cancer and hormonal contraception is complex and contradictory. Current research suggests that women who use hormonal contraception appear to have a small increase in risk of being diagnosed with breast cancer compared to women who don’t use hormonal contraception. Further research is ongoing.

When can I start using an implant?

An implant will usually be put in during the first 5 days of your period. You will be immediately protected against becoming pregnant.

If the implant is put in on any other day you will not be protected against pregnancy for the first 7 days after it has been fitted. So you will need to use another method of contraception, such as condoms, during this time.

How soon can I have an implant after having a baby, miscarriage or abortion?

You can have an implant put in 3 weeks (21 days) after you have given birth. If the implant is put in before day 28 you will be protected from pregnancy immediately. If the implant is put in later than day 28 you will need to use an extra method of contraception for 7 days. 

The implant can be put in immediately after an abortion or miscarriage if you were pregnant for less than 24 weeks. You will be protected against pregnancy immediately.

Can I use an implant if I am breastfeeding?

Yes. The implant is safe to use when you are breastfeeding. It will not affect your milk supply or harm the baby.

How is an implant put in?

The implant, which is the size of a hair grip, is placed just under your skin in the inner area of your upper arm. It must be put in by a doctor or nurse who has been trained to insert implants. They will give you a local anaesthetic to numb the part of your arm where the implant will go, so it won’t hurt as it is put in. It only takes only a few minutes to put in and feels similar to having an injection. You won’t need any stitches. After it has been fitted the doctor or nurse will check your arm to make sure that the implant is in position.

The area may be tender for a day or two and may be bruised and slightly swollen. The doctor or nurse will put a dressing on it to keep it clean and dry and to help stop the bruising. Keep this dressing on for a few days and try not to knock the area.

Don’t worry about knocking the implant once the area has healed. It should not break or move around your arm. Most women can feel the implant with their fingers, but usually you can’t see it. It won’t affect you moving your arm and you will be able to do normal activities.

You do not need to have a vaginal examination or cervical smear to have an implant inserted.

How is an implant taken out?

An implant can be left in place for 3 years or it can be taken out sooner if you decide you want to stop using it.  A specially trained doctor or nurse must take it out. The doctor or nurse will feel your arm to locate the implant and then give you a local anaesthetic injection in the area where the implant is. They will then make a tiny cut in your skin and gently pull the implant out through the opening. They will put a dressing on the arm to keep it clean and dry and to help stop the bruising. Keep this dressing on for a few days.

It usually only takes a few minutes to remove an implant. If the implant has been put in correctly, it should not be difficult to remove. Occasionally, an implant is difficult to feel under the skin and it may not be so easy to remove. If this happens, your doctor or nurse may refer you to a specialist centre to have it removed with the help of an ultrasound scan.

If you want to carry on using an implant, the doctor or nurse can put a new one in at the same time. You will continue to be protected against pregnancy.

If another implant is not put in you will stop being protected against pregnancy immediately.

Can anything make an implant less effective?

Some medicines may make an implant less effective. These include some of the medicines used to treat HIV, epilepsy and tuberculosis, and the complementary medicine St John’s Wort. These are called enzyme inducers. If you are using these medicines it will be recommended that you use additional contraception, such as condoms, or that you change your method of contraception. Always tell your doctor, nurse or dentist that you are using an implant if you are prescribed any medicines. The Implant is not affected by common antibiotics, diarrhoea or vomiting.

It is important to have your implant changed at the right time. If it is not changed at the right time you will not be protected against pregnancy. If you have sex without using another method of contraception and don’t wish to become pregnant you may want to consider using emergency contraception (see Emergency contraception).

How will an implant affect my periods?

Your periods will probably change.

  • In some women periods will stop completely

  • Some women will have irregular periods or spotting (bleeding between periods)

  • Some women will have periods that last longer and are heavier.

These changes may be a nuisance but they are not harmful.

If you do have prolonged bleeding it may be possible for the doctor or nurse to give you some additional hormone or medicine that can help control the bleeding. They may also check that the bleeding is not due to other causes, such as an infection.

What should I do if I want to stop using the implant or try to get pregnant?

If you want to stop using the implant you need to go back to the doctor or nurse and ask them to take it out. Your periods and natural fertility are likely to return quickly and it is possible to get pregnant before you have your first period. If you don’t wish to become pregnant then you should use another method of contraception from the day that your implant is removed.

If you want to try for a baby it helps to wait for one natural period before trying to get pregnant. This means that the pregnancy can be dated more accurately and you can start pre-pregnancy care such as taking folic acid and stopping smoking. You can ask your doctor or nurse for further advice. Don’t worry if you do get pregnant sooner, it will not harm the baby.

If I have to go into hospital for an operation should I stop using the implant?

No. It is not necessary to stop using the implant if you are having an operation. However, it is always recommended that you tell the doctor that you are using the implant.

How long can I use the implant for?

If you have no medical problems you can continue to use the implant until you reach the menopause. Each implant will last for 3 years and will then need to be changed.

What should I do if I think that I am pregnant?

The implant is a highly effective method of contraception. If you have not taken any medicine that might make the implant less effective and have had the implant changed on time it is very unlikely that you will become pregnant.  If you think that you might be pregnant then you can do a pregnancy test or speak to your doctor or nurse as soon as possible. If you do get pregnant while you are using the implant it will not harm the baby.

Are there any other types of implants?

At one time in the UK a contraceptive implant called Norplant was available. This consisted of 6 rods that were placed under the skin of the arm and provided protection from pregnancy for 5 years. Although this is no longer available in the UK some women may still be using this type of implant.

How often do I need to see a doctor or nurse?

You only need to go to the clinic or your general practice if you have any problems with your implant or when it needs to be replaced. If you have any problems you should contact your doctor or nurse.

How do I find out about contraception services?

Contraception is free for women and men of all ages through the National Health Service.

  • You can find out about all clinics from sexual health direct, run by fpa on 0845 310 1334 or visit the website www.fpa.org.uk

  • You can get lists of general practices from libraries, primary care trusts or health boards and some advice centres and helplines.

  • You can get details of your nearest family planning or sexual health clinic from: local directories, health centre, hospital, midwife or health visitor, advice centre, NHS Direct on 0845 46 47 (NHS 24 in Scotland 0845 4 24 24 24), primary care trust or health board.

  • Young people can also phone Brook on 0800 0185 023 or Sexwise on 0800 28 29 30 for details of the nearest young people’s clinic.

Emergency contraception

If you have had sex without using contraception or think your method might have failed there are two emergency methods you can use.

  • The emergency hormonal pill – must be taken up to 3 days (72 hours) after sex. It is more effective, the earlier it is taken after sex

  • An IUD – must be fitted up to 5 days after sex, or up to 5 days after the earliest time you could have released an egg (ovulation)


Ask your doctor or nurse about getting emergency pills in advance, just in case you need them.

Sexually transmitted infections

Most methods of contraception do not protect you from sexually transmitted infections.

Male and female condoms, when used correctly and consistently, can help protect against sexually transmitted infections. Diaphragms and caps may also protect against some sexually transmitted infections. If you can, avoid using condoms containing Nonoxinol 9 (spermicidally lubricated), as this does not protect against HIV and may even increase the risk of infection.

How fpa can help you

sexual health direct is a nationwide service run by fpa. It provides:

  • confidential information and advice on contraception, sexually transmitted infections, planning a pregnancy, pregnancy choices and sexual wellbeing

  • details of family planning clinics, sexual health clinics and other sexual health services

  • a wide range of leaflets on individual methods of contraception, common sexually transmitted infections, abortion and planning a pregnancy.

fpa helplines

UK
helpline 0845 310 1334
9am to 6pm Monday to Friday

Northern Ireland
helpline 028 90 325 488 (Belfast) or
helpline 028 71 260 016 (Derry)
9am to 5pm Monday to Thursday, 9am to 4.30pm Friday

Scotland
helpline 0141 576 5088
9am to 5pm Monday to Thursday, 9am to 4.30pm Friday

or visit fpa's website
www.fpa.org.uk

A final word

This leaflet can only give you basic information about the contraceptive implant. The information is based on the evidence and medical opinion available at the time this leaflet was printed. Different people may give you different advice on certain points. All methods of contraception come with a Patient Information Leaflet which provides detailed information about the method.


Remember – contact your doctor, practice nurse or a family planning clinic if you are worried or unsure about anything.

Registered charity number 250187

Supported by the Department of Health.
© fpa

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