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 slowly releasing a progestogen hormone into the body. Implanon NXT is the brand available in Australia.

Implanon

How does it work?

Progestogen 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

 

How effective is it?

It is an extremely effective method of contraception (99.95%).

 

How do I get the implant?

Two appointments may be 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 or nurse trained in this procedure.

 

How is it inserted?

An area on the inner arm above the elbow is first numbed with local anaesthetic. Then the doctor or nurse puts the implant under the skin. After the implant is inserted, a band aid or dressing is put on which should stay on for 3-5 days. The arm is bandaged to reduce bruising and this should be left on for 24 hours.

 

When does it start working?

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.

 

How long does it last?

It is effective as a contraceptive for 3 years. The implant should be taken out and replaced with a new implant every 3 years. It can be removed earlier than 3 years if it is no longer wanted.

 

How do I stop using it?

To stop using the implant it needs to be removed by a doctor or nurse. 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.

 

When will I be fertile again?

Progestogen levels are not detectable within a week of removal. Most people 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 are the benefits of the implant?

  • It is highly effective.
  • It lasts a long time (up to three years).
  • It is reversible and the return to fertility is rapid.
  • It does not need you to remember to take a pill every day.
  • It is a cost-effective method of contraception.
  • It may reduce painful periods, premenstrual syndrome (PMS) and acne in some people.

 

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
  • occasional bleeding may happen without a regular period
  • increased bleeding happens sometimes, this can include
    bleeding more often, heavier bleeding or a combination of this

Many people have no other side effects. Some may experience the following problems:

  • Acne may develop, improve or get worse.
  • Weight gain can occur over time and is often thought to be caused by the implant, but has not been directly proven.
  • Headaches, breast pain and mood changes can occur and may go away after the initial few weeks.
  • Bruising and mild soreness at the site of insertion or removal can last up to 2 weeks. A small scar remains.

Occasionally the implant can be difficult to feel or remove and you may need to have an ultrasound to check its position in your arm.

 

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 the bleeding does not settle or you are unhappy with the bleeding you can see a doctor for medications that can help with this. You don’t have to wait until 3 months to do this.

 

Who can use the implant?

This method suits most people with a uterus, no matter what age up to menopause, who don’t mind having an implant under their skin. It’s safe for heavy smokers and people with diabetes, high blood pressure and high cholesterol.

 

Who should NOT use the implant?

People who are pregnant, people with breast cancer, people with unexplained vaginal bleeding, people with severe liver disease or using medication that affects the liver, should not use the implant.

 

Where can I get the implant?

The implant is prescribed by a doctor and can be inserted at SHINE SA clinics and by doctors, nurses and gynaecologists who have been trained in this procedure.

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