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Contraceptive implant

Contraceptive implant
Contraceptive implants are a long-term birth control option for women. A contraceptive implant
is a flexible plastic rod about the size of a matchstick that is placed under the skin of the upper
arm.

It releases a low, steady dose of a progestational hormone to thicken cervical mucus and thin the
lining of the uterus (endometrium). Contraceptive implants typically suppress ovulation as well.

One version of contraceptive implant — Implanon — was discontinued by its manufacturer in

2014 and replaced with a newer version called Nexplanon. Nexplanon is radio opaque, which
means it can be seen on X-ray, which is useful for checking the location of the implant.

Why it's done

Contraceptive implants offer effective, long-term contraception. Among various benefits, a

contraceptive implant:

 Can be removed at any time, followed by a quick return to fertility

 Eliminates the need to interrupt sex for contraception

  Contains no estrogen

Contraceptive implants aren't appropriate for everyone, however. Your health care provider may
discourage use of a contraceptive implant if you:

 Are allergic to any components of the implant

 Have had serious blood clots, a heart attack or a stroke

 Have liver tumors or liver disease

 Have known or suspected breast cancer or a history of breast cancer

 Have undiagnosed abnormal genital bleeding

Although the label for etonogestrel (Nexplanon) says it shouldn't be used by women with a
history of blood clots, it isn't clear whether the contraceptive implant affects the risk of blood
clots. The warning comes from studies of combination birth control pills that contain the same
progestin as is used in the contraceptive implant.

Talk to your health care provider if you have any risk factors for blood clots, including a history
of blood clots in your legs or a prior diagnosis of a blood clot in your lungs (pulmonary
embolus).

In addition, tell your health care provider if you have a history of:

 An allergic reaction to anesthetics or antiseptics

 Depression

 Diabetes

 Gallbladder disease

 High blood pressure

 High cholesterol or high triglycerides

 Seizures or epilepsy

The contraceptive implant isn't contraindicated for use in women who are overweight. However,
it's possible the device may not be as effective in women with a body mass index (BMI) above
30.
Certain medications and herbal products may decrease the levels of progestin in your blood,
which can decrease the contraceptive implant's effectiveness. Medications known to interact with
the contraceptive implant include some seizure medications, certain sedatives, some HIV
medications, as well as the herb St. John's wort. Talk with your doctor about your contraceptive
options if you take any of these medications.

 Risks

The contraceptive implant doesn't offer protection from sexually transmitted infections.

Fewer than 1 out of 100 women who use the contraceptive implant for one year will get
pregnant. If you do conceive while using a contraceptive implant, there's a higher chance that the
pregnancy will be ectopic — when the fertilized egg implants outside the uterus, usually in a
fallopian tube. However, because a contraceptive implant prevents most pregnancies, women
who use it are at lower risk of having an ectopic pregnancy than are other sexually active women
who aren't using contraception.

Side effects associated with contraceptive implants include:

 Abdominal or back pain

 An increased risk of noncancerous ovarian cysts

 Changes in vaginal bleeding patterns, including absence of menstruation (amenorrhea)

 Decreased sex drive

 Dizziness

 Headaches

 Mild insulin resistance

 Mood swings and depression

 Nausea or upset stomach

 Potential interaction with other medications

 Sore breasts

 Vaginal inflammation or dryness

  Weight gain

How you prepare

Your health care provider will evaluate your overall health before inserting the contraceptive
implant. He or she will determine the appropriate timing for the insertion of the implant based on
your menstrual cycle and your previous birth control method. You may need to take a pregnancy
test and use a nonhormonal backup method of contraception for one week.

A backup method of contraception may not be necessary if you previously:

 Used no contraception and have the contraceptive implant inserted during the first five days
of your menstrual cycle, even if you're still bleeding

 Used combination birth control pills, a vaginal ring or a patch for birth control and have the
contraceptive implant inserted within seven days of the start of your hormone-free period

 Used the minipill and have the contraceptive implant inserted while taking active pills

 Used a contraceptive injection and have the contraceptive implant inserted the day your
next injection is due

 Used another contraceptive implant or an intrauterine device (IUD) and have the
etonogestrel implant (Nexplanon) inserted the day your previous device is removed

What you can expect

Insertion of contraceptive implant

You can have a contraceptive implant inserted during a visit to your health care provider's office.
The actual procedure takes just a minute or so, though preparation will take a bit longer.

During the procedure

You'll lie on your back with the arm that will receive the implant bent at the elbow and
positioned near your head. Your health care provider will locate a groove between the biceps and
triceps muscles on the inner side of your upper arm. He or she will inject a local anesthetic and
then use an applicator to insert the device just beneath your skin. Inserting the device too deeply
makes removal difficult.

After the procedure

Your health care provider will feel your arm to confirm the presence of the implant and have you
do the same. If necessary, he or she may also use an ultrasound or X-ray to confirm that the
device has been inserted.

Your health care provider will cover the insertion site with a small bandage. He or she may also
apply a pressure bandage to minimize bruising. You can remove the pressure bandage in 24
hours, but keep the small bandage clean and in place for three to five days.

It's common to experience some degree of bruising, pain, scarring or bleeding at the insertion
site.

Contact your health care provider if you develop:

 Breast lumps

 Heavy, prolonged vaginal bleeding

 Signs or symptoms of a blood clot in your leg, such as persistent pain and swelling in your
calf

 Signs or symptoms of jaundice, such as yellowing of the skin or whites of the eyes

 Signs or symptoms of an infection at the insertion site, such as tenderness, redness,

swelling or discharge

 Signs or symptoms of pregnancy at any time after the contraceptive implant is inserted
Removal

The contraceptive implant can prevent pregnancy for up to three years. It must be removed and
replaced at the three-year point to continue offering protection from unintended pregnancy.

Your health care provider may recommend removing the contraceptive implant earlier if you
develop:

 Migraine with aura

 Heart disease or stroke

 Uncontrolled high blood pressure

 Jaundice

 Significant depression

To remove the device, your health care provider will inject a local anesthetic in your arm beneath
the implant. He or she will make a small incision in your skin and will push the implant toward
the incision until the tip is visible and can be grasped with forceps.

Your health care provider will then pull out the implant, close the incision and apply a pressure
bandage. Contraceptive implant removal typically takes less than five minutes.

If you choose, a new device can be implanted as soon as the original device is removed. Be
prepared to use another type of contraception right away if you don't have a new device inserted.

Results

A contraceptive implant can prevent pregnancy for up to three years. It must be removed and
replaced every three years to continue prevent pregnancy.

Reference: https://www.mayoclinic.org/tests-procedures/contraceptive-implant/about/pac-
20393619
Birth Control Implant

What is the birth control implant?

The birth control implant (AKA Nexplanon) is a tiny, thin rod about the size of a matchstick.
The implant releases hormones into your body that prevent you from getting pregnant. A nurse
or doctor inserts the implant into your arm and that’s it — you’re protected from pregnancy for
up to 5 years. It’s get-it-and-forget-it birth control.

How does the implant work?

The birth control implant is a tiny, thin rod about the size of a matchstick. It’s also called
Nexplanon and there’s a slightly older version called Implanon. A doctor inserts the implant
under the skin of your upper arm. It releases the hormone progestin to stop you from getting
pregnant.

The hormones in the birth control implant prevent pregnancy in two ways:

 Progestin thickens the mucus on your cervix, which stops sperm from swimming through
to your egg. When sperm can’t meet up with an egg, pregnancy can’t happen.
 Progestin can also stop eggs from leaving your ovaries (called ovulation), so there’s no
egg to fertilize. When eggs aren’t released, you can’t get pregnant.

One of the awesome things about the implant is that it lasts for a long time — up to 5 years —
but it’s not permanent. If you decide you want to get pregnant or you just don’t want to have
your implant anymore, your doctor can take it out. You’re able to get pregnant quickly after the
implant is removed. You can keep track of your insertion and removal dates using our birth
control app.

Does the implant prevent STDs?

Nope. Nexplanon doesn't protect against STDs. Luckily, using condoms or internal
condoms every time you have sex does lower your chances of getting or spreading STDs. So
using condoms with your implant is the best way to prevent infections.

Reference: https://www.plannedparenthood.org/learn/birth-control/birth-control-implant-
implanon