Contraceptive Implant (Implanon)

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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 NXT is the brand available in Australia.

Progestogen is a hormone which works by:

  • stopping the release of an egg by the ovary (ovulation)
  • making the mucus (sticky fluid) at the opening of the uterus thicker so sperm can’t get through
  • changing the lining of the uterus so a fertilised egg can’t take hold

It is an extremely effective method of contraception (99.9%).

Two appointments are required. The first appointment is with your doctor or SHine SA to discuss this method and get a prescription. The second appointment, to insert the implant, needs to be with a doctor trained in this procedure.

An area on the inner arm above the elbow is first numbed with local anaesthetic. Then the doctor puts the implant under the skin. After the implant is inserted, the arm is bandaged to reduce bruising. The bandage should be left on for 24 hours.

It’s immediately effective if inserted during the first 5 days of your menstrual cycle, which starts with the first day of bleeding.

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.

It’s effective as a contraceptive for 3 years. The implant should be taken out and replaced with a new implant every 3 years.

To stop using the implant it needs to be removed by a doctor. This involves an injection of local anaesthetic and a small cut to the skin to find the tip of the implant and remove it. It usually takes 5-10 minutes.

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.

Implanon NXT is the cost of a standard prescription (about $35). If you have a Health Care or Pension Card it’s the standard concession charge. There may be an extra charge for appointments with your doctor.

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 remains.

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 3-5 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.

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 people with diabetes.

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.

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