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Information about contraceptive implant

What is the contraceptive implant?

The contraceptive implant is a small plastic rod containing a progestogen hormone. Inserted under the skin on the underside of the upper arm, the hormone is released slowly from the implant into the bloodstream over three years.

The contraceptive implant is very flexible and not easily visible. Nexplanon® is the brand name of the contraceptive implant available in UK.

How does it work?

The contraceptive implant prevents pregnancy by:

  • stopping the body from releasing an egg every month

  • making the mucus in the cervix (entrance to your womb) thicker, so sperm cannot get through

  • changing the lining of the uterus (womb).

How effective is it?

The contraceptive implant is over 99% effective at preventing pregnancy and lasts up to three years, but can be removed at any time.

It is very effective as a contraceptive and user friendly (you don’t need to remember to take a pill every day!) It is rapidly reversible if you have plans to start a family and has no effects on fertility.

Who can use it?

The contraceptive implant is suitable for those who:

  • are looking for very effective and reliable long-term contraception that is ‘fit and forget’

  • cannot take oestrogen

  • have difficulty remembering to take daily contraception

  • are breastfeeding

The contraceptive implant is not suitable for those who:

  • have had breast cancer within the last five years

  • have undiagnosed abnormal vaginal bleeding

  • if you are on certain medications

 

When can the implant be inserted?

  • The contraceptive implant can be inserted at any time that pregnancy can confidently be excluded

  • It is effective immediately if it is inserted between day one (first day of bleeding) to day five of your menstrual cycle

  • If inserted at any other time of the cycle, back up contraception such as condoms should be used for the next 7 days.

Risks from having the contraceptive implant fitted

Implant insertions are a generally safe, the most common complications include:

  • Very rarely you may get an infection in your arm where the implant has been fitted

  • Rarely, the implant may be inserted too deeply into your arm.  It can be removed by an experienced healthcare professional

  • Very rarely, the implant may be inserted into a blood vessel and may move to a different area of the body.  If this happens, an operation is needed to remove it.

 

Disadvantages of the contraceptive implant

  • Your periods may change in a way that is not acceptable to you.

    • It is common for it to be unpredictable and it may change at any time over the 3 years the implant lasts.
    • 1 in 5 implant users will have irregular bleeding.   Problematic bleeding in the first few months after the implant is fitted will improve over time for 1 in 2 women.
    • Sometimes bleeding stops completely, a few implant users will have bleeding that’s more frequent or lasts longer
    • These changes may be a nuisance but they are not harmful
  • You may get side effects like headaches, breast tenderness or mood changes

  • You may get acne or your acne may get worse

  • It won’t work if you are on certain medications known as enzyme-inducing drugs – see below.

  • An implant doesn’t protect you from sexually transmitted infections, so you need to use condoms as well.

Can anything make the implant less effective?

  • Some medications can affect the implant.  These are called enzyme-inducing drugs and include medicines used to treat HIV, epilepsy and tuberculosis as well as the supplement St John’s Wort.   If you are taking these medications you will need to use additional contraception such as condoms or consider a different method of contraception.

  • The implant is not affected by common antibiotics, vomiting or diarrhoea

  • It is important to have your implant changed at the right time – if not you won’t be protected from pregnancy.   It is a good idea to make a note of when it will need replacing so you can arrange this in good time.

What happens on the day of the procedure?

  • Insertion by a trained health professional only takes a couple of minutes

  • A very small amount of a local anaesthetic is injected into the surface layers of your skin to numb the area where the implant is being inserted.  This can sting for a short while.

  • The contraceptive implant is inserted using a special applicator, no stitches are required

  • After it’s been inserted, we will check your arm to make sure it is in the correct place

  • You will also be shown how to feel the implant with your fingers to check it’s in place.

  • The area may be tender for a day or two, and may be bruised or slightly swollen

  • You will be given a dressing on it to keep it clean and dry and to help reduce any bruising.  Keep this dressing on for a few days and try not to knock the area.

  • Once the area has healed you don’t need to worry about knocking the implant.  It shouldn’t break or move around your arm.  You will be able to do normal activities and you won’t be able to see it.

How is the implant removed?

  • The implant can be left in place for 3 years, but it can be removed sooner if you want to stop using it

  • A specially trained healthcare professional will feel your arm to locate the implant

  • A local anaesthetic will be injected into the area around the implant

  • A tiny cut will be made in your skin, and the implant gently pulled out.

  • Steristrips and a dressing will be put on the arm to keep it clean and dry, and to help reduce any bruising.  Keep this dressing on for a few days.

  • It usually only takes a few minutes to remove an implant.  Occasionaly an implant is difficult to feel under the skin and it may not be so easy to remove.  If this happens you may be referrred to a specialist centre to have it removed with the help of an ultrasound scan

  • If you want to carry on using an implant you can get a new one inserted at the same time.  You will then continue to be protected from pregnancy.  If you are not having a new implant fitted, you will need to consider future contraceptive needs as the contraceptive effects will stop as soon as it is removed and it is possible to get pregnant before you have your first period after the implant has been removed.

Important information before your appointment

Please read the information on this page carefully and ask your doctor or nurse if there is anything that you do not understand. You will be asked to confirm that you have read and understood all the information especially the points below before we can go ahead with your appointment.

  • You must be confident you are not pregnant; please confirm you do not see any reason why you could be pregnant.

  • If you have an implant or coil already or use condoms, diaphragm or other natural methods of contraception please confirm you have abstained from sex for the last 7 days prior to the procedure..

  • If you take the pill, combined or progesterone only, have an implant already or use condoms, diaphragm or other natural methods of contraception please confirm that you have taken the pill correctly for the last 7 days prior to the procedure.

  • If you have an implant, coil or injection please confirm that you are not overdue a new coil, injection or implant and therefore that your current contraceptive method is still working.

  • Please allow at least half an hour for the appointment. Although the procedure does not take this long, a few women feel faint afterwards and need time to recover. Please confirm you are aware of this. It is recommended that you have someone you can contact by phone, who would be able to collect you, in case you feel unwell.

  • Please note that you should abstain from unprotected sexual intercourse for seven days after the fitting, unless it has been fitted in the first 5 days of your period.

  • I am aware the contraceptive implant is licenced for THREE YEARS and that it is my responsibility to call the surgery to get a replacement when the THREE years are up.

Please complete the form below, once we have received your response we will be in touch to arrange an appointment

 

Contraceptive Implant Consent Form

Name(Required)
MM slash DD slash YYYY
Address(Required)
I confirm I have read the information provided to me and am aware of the potential side effects and complications of the contraceptive implant that have been described above. By submitting this form, I am implying consent for the procedure.(Required)