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What is the Contraceptive Implant?

The Implant is a Long Acting Reversible Method (LARC). It is a small, flexible rod about the size of a matchstick. It contains a progestogen hormone which provides contraception (prevents pregnancy) without you having to take a daily pill. The rod is put under the skin on your arm. 

The only contraceptive implant currently available in the UK is Nexplanon® (there are other devices available elsewhere in the world).

How does it work and how effective is it?

It works by stopping ovulation, thins the lining of the uterus and changes the cervical mucus.

It has high efficacy rates against pregnancy, and you don’t have to remember to take it.

It lasts for 3 years and lives in your non-dominant upper arm where you can feel the device under your skin, but once in, we advise that you leave it alone

It takes 7 days for the Implant to be effective.

What are the potential side effects?

Bleeding changes are the main side effect implant users encounter and the commonest reason given when patients request for an implant to be removed early. 

Once fitted, 1/3 people report no bleeding, 1/3 people experience irregular bleeding and 1/3 people experience bleeding every day. 

If you experience constant bleeding (and there are no contraindications in your medical history) you can have the Combined Hormonal Contraceptive (CHC) pill on top of having the implant which helps regulate bleeding. 

If the bleeding is constant and you are unable to have CHC, we can offer an alternative medication to try and regulate bleeding, called mefenamic acid or removal of the implant.

Skin changes can be variable with some users having new onset or worsening of existing acne while others have an improvement in existing acne.

Headache is commonly reported but there is a lack of evidence to confirm or exclude that this is definitely linked to the implant 

Mood changes, change in appetite or weight – has been reported but there is a lack of evidence to confirm or exclude a definite causative link with the implant. 

We advise you to give the Implant a 3-6 months trial to allow for side effects to settle.

Fitting Procedure

You will be asked to complete a questionnaire on booking which include screening questions regarding risk of pregnancy.

We advise no pregnancy risk either by abstaining from sex for 3 weeks or effective use of a contraceptive method. 

The procedure is quick, using local anaesthetic to numb the area, the device is inserted using a pre-loaded lancet. 

We advise you feel the device once fitted, then leave it alone. 

We place a bandage on the site for 24hrs and you can resume any activities following the procedure. 

The Implant takes 7 days to be effective so use of condoms or abstinence until 7 days have passed, unless this is a replacement implant and within the 3 year expiry date, or day 1-5 of cycle.

We will provide this Patient Information Leaflet and card for a reminder of when the device expires.

Removal

Removal of the Implant is via a “pop out” technique. 

Using local anaesthetic to numb the area, and going through the same scar that the implant was fitted, we make a small hole and ease the implant out via a pop out technique. 

We use steri-strips to close the small hole, place a plaster onto the site and wrap a bandage around the arm and cover for 48 hrs to stop bleeding and reduce infection risk. The bandage can come off after 24 hrs and plaster and steri-strips after 48hrs. It must remain clean and dry to stop infection.

Fertility returns immediately.

If there are any difficulties in removing the Implant a referral will be made on your behalf to a Specialist Deep Implant Clinic.

Further information can be found on the Contraceptive Implant Page of the Patient Access website.