Contraceptive implant (Implanon)
What is the contraceptive implant?
It is a white plastic rod that is inserted under the skin of the inner, upper arm to stop pregnancy by releasing constant small amounts of progestogen into the body. Implanon is the brand available in Australia.
How does it work?
Progestogen is a hormone which works by:
- stopping the release of an egg by the ovary (ovulation)
- making the mucus (sticky fluid) at the entrance of the uterus thicker so sperm can't get through
- changing the lining of the uterus so a fertilised egg can't grow
How effective is it?
It is an extremely effective method of contraception (99.9%).
How do I get the implant?
Two appointments are required. The first appointment is with your doctor, SHine SA or The Second Story to discuss this method and get a prescription. The second appointment is with a doctor trained in this procedure to insert the implant.
What is the procedure?
The area on the inner arm above the elbow is first numbed with local anaesthetic. Then the implant is put under the skin with a special introducer. It is like having an injection. After the implant is inserted, the arm is bandaged to try to avoid any bruising. The bandage should be left on for 24 hours. If the arm feels sore take some paracetamol every 4 hours until it settles.
When does it start working?
It's immediately effective if inserted during the first 5 days after a period starts.
The implant is effective after 7 days if it is inserted at any other time in the menstrual cycle. Other contraceptive measures such as condoms should be used for these 7 days.
If changing from the Pill or another method of contraception discuss the best time for insertion with your doctor.
How long does it last?
It's effective as a contraceptive for 3 years. The implant should be taken out and replaced with a new implant every 3 years.
How do I stop using it?
To stop using the implant it needs to be removed. This has to be done by a trained doctor. It involves an injection of local anaesthetic and a small cut to the skin to find the tip of the implant and remove it. This usually takes 5-10 minutes.
When will I be fertile again?
Most women return to their normal menstrual cycle and fertility within a month of removing the implant. If you do not want to be pregnant you need to use other contraception as soon as it is removed.
What does it cost?
On prescription it's the cost of a standard prescription (about $30). If you have a Health Care or Pension Card it's the standard concession charge. There may be an extra charge for your doctor appointments.
What are the side effects?
Bleeding patterns are likely to change:
- periods may be at the normal times, but they may be lighter and less painful
- periods may stop altogether
- bleeding may happen at times when you are not due
- heavy, irregular bleeding happens sometimes and if it does not settle it may be a good reason to take the implant out
Many women have no other side effects. Some may experience the following problems.
Weight gain can occur, but it is often not due to the implant alone.
Headaches, breast pain and mood changes can occur and may go away after the initial few weeks.
Painful periods and acne usually improve with the implant, though a small number of women will find that they can develop these problems for the first time after the implant is inserted.
Bruising and mild soreness at the site of insertion or removal can last up to 2 weeks.
A small scar may be seen.
What should I do if I get frequent or heavy bleeding?
Irregular bleeding is a common side effect and will usually settle down within 3 months. Whatever your bleeding pattern, the implant is still effective. If bleeding persists you can take Ponstan, Nurofen or other period pain drugs in the recommended normal daily dose for up to 5 days.
If bleeding still persists you can make an appointment with your doctor who may choose one of three options:
- tranexamic acid - two tablets taken three times a day for at least a week
- extra progestogen (e.g. progestogen-only pill) for 4-6 weeks
- oestrogen for 4-6 weeks (either the Pill or hormone replacement therapy)
If the bleeding does not settle it may be best to consider another method of contraception.
Who should NOT use the implant?
Pregnant women, women with breast cancer, women with unexplained vaginal bleeding, women with severe liver disease or using medication that affects the liver, should not use the implant.
Who can use the implant?
This method suits most women, from young women to women around menopause, who don't mind having an implant under their skin. It's relatively safe for heavy smokers and diabetics to use.
Am I at risk of sexually transmitted infections?
The implant does not protect you against sexually transmitted infections. Condoms are the only form of contraception that will help protect you from infection.
This information is available to download in leaflet format as Contraceptive implant (PDF)