Contraceptive
Implant
An implant is a small flexible rod that is placed
just under your skin in your upper arm. It releases
a progestogen hormone similar to the natural progesterone
that women produce in their ovaries. It is a very
effective, long-term hormonal method of contraception
which protects you from pregnancy for up to 3 years.
The implant that is available in the UK is called
Implanon. How
effective is an implant?
How does an implant
work?
Where can I get an implant?
Can anyone use an implant?
How long is an implant effective
for?
What are the advantages
of an implant?
What are the disadvantages
of an implant?
Are there any risks?
When can I start using an implant?
How soon can I have an implant
after having a baby, miscarriage or abortion?
Can I use an implant
if I am breastfeeding?
How is an implant put in?
How is an implant taken out?
Can anything make an
implant less effective?
How will an implant affect
my periods?
What should I do if I want
to stop using the implant or try to get pregnant?
If I have to go into hospital
for an operation should I stop using the implant?
How long can I use the implant
for?
What should I do if I
think that I am pregnant?
Are there any other types of
implants?
How often do I need to see a
doctor or nurse?
How effective is an implant?
How
effective any contraceptive is depends on how
old you are, how often you have sex and whether
you follow the instructions.
If
100 sexually active women don’t use any
contraception, 80 to 90 will become pregnant in
a year.
If
you follow the instructions, implants are over
99% effective. This means that less than 1 woman
in 100 who use an implant will get pregnant in
a year.
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How does an implant work?
The
main way it works is to stop your ovaries releasing
an egg each month (ovulation). It also:
•
Thickens the mucus from your cervix. This makes
it difficult for sperm to move through your cervix
and reach an egg
• Makes the lining of your
womb thinner so it is less likely to accept a
fertilised egg.
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Where can I get an implant?
Only
a doctor or nurse who has been trained to fit
implants can insert the implant. You can go to
a family planning clinic or to the doctor or nurse
at your general practice. If you prefer not to
go to your own general practice, or they don’t
provide contraceptive services, they can give
you information about another practice or clinic.
All treatment is free and confidential.
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Can anyone use an implant?
Most
women who want to use an implant can have one
fitted. The doctor or nurse will need to ask you
about your own and your family’s medical
history to make sure that the implant is suitable.
You should tell them about any illnesses or operations
you have had. An implant may not be suitable for
you if:
•
you think you might already be pregnant
• you do not want your
periods to change
• you take certain medicines.
• you have now, or have
had in the past:
-
breast cancer
- unexplained vaginal bleeding (for example, bleeding
between periods or after sex)
- thrombosis (blood clots) in any vein
- a heart attack or stroke (serious arterial disease)
- active liver disease
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How long is an implant effective for?
An
implant is designed to be used for 3 years and
is a long-term method of contraception. If you
are not sure you want contraceptive protection
for this long, other methods may be more suitable
for you.
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What are the advantages of an implant?
•
You don’t have to think about contraception
for as long as the implant lasts.
• It does not interrupt
sex.
• You can use it if you
are breastfeeding.
• It is a good method if
you cannot use estrogens (hormones), like those
in the combined pill.
• Your normal level of
fertility will return as soon as the implant is
taken out.
• It offers some protection
against pelvic inflammatory disease.
• It may give you some
protection against cancer of the womb.
• It may reduce heavy,
painful periods.
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What are the disadvantages of an implant?
•
Your periods may change in a way that
is not acceptable to you (see How
will an implant affect my periods?).
• Other possible side-effects
include headaches, spotty skin, putting on weight,
tender breasts, bloating, and changes in mood
and sex drive.
• It requires a small procedure
to insert and remove it (see How
is an implant put in? and How
is an implant taken out?)
• An implant does not protect
you against sexually transmitted infections, so
you may need to use condoms as well.
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Are there any risks?
•
Very rarely, soon after the implant is
put in it can cause an infection in your arm,
where it has been inserted.
• Research about the risk
of breast cancer and hormonal contraception is
complex and contradictory. Current research suggests
that women who use hormonal contraception appear
to have a small increase in risk of being diagnosed
with breast cancer compared to women who don’t
use hormonal contraception. Further research is
ongoing.
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When can I start using an implant?
An
implant will usually be put in during the first
5 days of your period. You will be immediately
protected against becoming pregnant.
If
the implant is put in on any other day you will
not be protected against pregnancy for the first
7 days after it has been fitted. So you will need
to use another method of contraception, such as
condoms, during this time.
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How soon can I have an implant after having a
baby, miscarriage or abortion?
You
can have an implant put in 3 weeks (21 days) after
you have given birth. If the implant is put in
before day 28 you will be protected from pregnancy
immediately. If the implant is put in later than
day 28 you will need to use an extra method of
contraception for 7 days.
The
implant can be put in immediately after an abortion
or miscarriage if you were pregnant for less than
24 weeks. You will be protected against pregnancy
immediately.
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Can I use an implant if I am breastfeeding?
Yes.
The implant is safe to use when you are breastfeeding.
It will not affect your milk supply or harm the
baby.
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How is an implant put in?
The
implant, which is the size of a hair grip, is
placed just under your skin in the inner area
of your upper arm. It must be put in by a doctor
or nurse who has been trained to insert implants.
They will give you a local anaesthetic to numb
the part of your arm where the implant will go,
so it won’t hurt as it is put in. It only
takes only a few minutes to put in and feels similar
to having an injection. You won’t need any
stitches. After it has been fitted the doctor
or nurse will check your arm to make sure that
the implant is in position.
The
area may be tender for a day or two and may be
bruised and slightly swollen. The doctor or nurse
will put a dressing on it to keep it clean and
dry and to help stop the bruising. Keep this dressing
on for a few days and try not to knock the area.
Don’t
worry about knocking the implant once the area
has healed. It should not break or move around
your arm. Most women can feel the implant with
their fingers, but usually you can’t see
it. It won’t affect you moving your arm
and you will be able to do normal activities.
You
do not need to have a vaginal examination or cervical
smear to have an implant inserted.
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How is an implant taken out?
An
implant can be left in place for 3 years or it
can be taken out sooner if you decide you want
to stop using it. A specially trained doctor or
nurse must take it out. The doctor or nurse will
feel your arm to locate the implant and then give
you a local anaesthetic injection in the area
where the implant is. They will then make a tiny
cut in your skin and gently pull the implant out
through the opening. They will put a dressing
on the arm to keep it clean and dry and to help
stop the bruising. Keep this dressing on for a
few days.
It
usually only takes a few minutes to remove an
implant. If the implant has been put in correctly,
it should not be difficult to remove. Occasionally,
an implant is difficult to feel under the skin
and it may not be so easy to remove. If this happens,
your doctor or nurse may refer you to a specialist
centre to have it removed with the help of an
ultrasound scan.
If
you want to carry on using an implant, the doctor
or nurse can put a new one in at the same time.
You will continue to be protected against pregnancy.
If
another implant is not put in you will stop being
protected against pregnancy immediately.
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Can anything make an implant less effective?
Some
medicines may make an implant less effective.
These include some of the medicines used to treat
HIV, epilepsy and tuberculosis, and the complementary
medicine St John’s Wort. These are called
enzyme inducers. If you are using these medicines
it will be recommended that you use additional
contraception, such as condoms, or that you change
your method of contraception. Always tell your
doctor, nurse or dentist that you are using an
implant if you are prescribed any medicines.
The
Implant is not affected by common antibiotics,
diarrhoea or vomiting.
It
is important to have your implant changed at the
right time. If it is not changed at the right
time you will not be protected against pregnancy.
If you have sex without using another method of
contraception and don’t wish to become pregnant
you may want to consider using emergency contraception
(see Emergency
contraception).
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How will an implant affect my periods?
Your
periods will probably change.
•
In some women periods will stop completely.
• Some women will have
irregular periods or spotting (bleeding between
periods).
• Some women will have
periods that last longer and are heavier.
These changes may be a nuisance but they are not
harmful.
If
you do have prolonged bleeding it may be possible
for the doctor or nurse to give you some additional
hormone or medicine that can help control the
bleeding. They may also check that the bleeding
is not due to other causes, such as an infection.
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What should I do if I want to stop using
the implant or try to get pregnant?
If
you want to stop using the implant you need to
go back to the doctor or nurse and ask them to
take it out. Your periods and natural fertility
are likely to return quickly and it is possible
to get pregnant before you have your first period.
If you don’t wish to become pregnant then
you should use another method of contraception
from the day that your implant is removed.
If
you want to try for a baby it helps to wait for
one natural period before trying to get pregnant.
This means that the pregnancy can be dated more
accurately and you can start pre-pregnancy care
such as taking folic acid and stopping smoking.
You can ask your doctor or nurse for further advice.
Don’t worry if you do get pregnant sooner,
it will not harm the baby.
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If I have to go into hospital for an operation
should I stop using the implant?
No.
It is not necessary to stop using the implant
if you are having an operation. However, it is
always recommended that you tell the doctor that
you are using the implant.
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How long can I use the implant for?
If
you have no medical problems you can continue
to use the implant until you reach the menopause.
Each implant will last for 3 years and will then
need to be changed.
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What should I do if I think that I am
pregnant?
The
implant is a highly effective method of contraception.
If you have not taken any medicine that might
make the implant less effective and have had the
implant changed on time it is very unlikely that
you will become pregnant. If you think that you
might be pregnant then you can do a pregnancy
test or speak to your doctor or nurse as soon
as possible. If you do get pregnant while you
are using the implant it will not harm the baby.
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Are there any other types of implants?
At
one time in the UK a contraceptive implant called
Norplant was available. This consisted of 6 rods
that were placed under the skin of the arm and
provided protection from pregnancy for 5 years.
Although this is no longer available in the UK
some women may still be using this type of implant.
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How often do I need to see a doctor or
nurse?
You
only need to go to the clinic or your general
practice if you have any problems with your implant
or when it needs to be replaced. If you have any
problems you should contact your doctor or nurse.
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