The contraceptive implant

   

The contraceptive implant

Everything you need to know about the implant

Interested in getting the contraceptive implant? Here's everything you need to know.

What is the implant?

The contraceptive implant (AKA Nexplanon) is a small flexible plastic rod that's placed under the skin in your upper arm by a doctor or nurse. It releases the hormone progestogen into your bloodstream to prevent pregnancy and lasts for 3 years.

The implant does what most contraceptives in the body do; thickens mucus around your cervix, thins your uterine lining and also prevents egg release (and hopefully your periods, over time). It's good to have a check up after the first three months of getting your implant put in, then once a year providing you’re not having problems with it.

Here's some facts about the implant from the NHS website:

  • it's more than 99% effective
  • it can be useful for women who can't use contraception that contains oestrogen
  • it's very useful for women who find it difficult to remember to take a pill at the same time every day.
  • the implant can be taken out if you have side effects.
  • you can have it removed at any time, and your natural fertility will return very quickly.
  • your periods may become irregular, lighter, heavier or longer.
  • a common side effect is that your periods stop (amenorrhoea). It's not harmful, but you may want to consider this before deciding to have an implant.
  • some medicines can make the implant less effective.
  • it doesn't protect against sexually transmitted infections (STIs), so you may need to use condoms as well.

Getting the implant put in

When the implant is put into your arm, usually on the first day of your period, you're likely to be given a local anaesthetic to help numb the area. The implant is then inserted under your skin – this will only take a few minutes and feels similar to having an injection.

Once it's in, expect your arm to be tender and bruised for a few days. You’ll be able to feel the implant and may be tempted to fiddle with it, but resist that temptation for a while! 

You will be protected straight away, if your implant is inserted in the first 5 days of your cycle. If not, you'll have to have protected sex for a week before you're protected from pregnancy.

Getting the implant removed

You can have the implant taken out whenever you like, but you're encouraged to keep it in for a minimum of three months to give it a fair chance to settle. 

If you'd like to remove your implant, call up your GP or local clinic to arrange an appointment. A doctor or nurse will need to make a tiny cut in your skin to gently pull the rod out. This will be done under local aneasthetic, so you won't feel any pain, but may feel a small tugging sensation.

You can get another one popped in right away if you want. However, if you want it permanently removed, you must use condoms during the week before it is removed, because sperm can live inside you for 7 days and you'll lost protection as soon as the implant is taken out.

Can I have it?

The only way you can know that is by talking to your doctor. Some GP surgeries don't perform the procedure so you might get referred on to a GUM clinic or clinic at your local hospital. 

It's usual for you to have a consultation first before you have the appointment for insertion of the implant. They want to make sure you're not pregnant before you go on the implant so there might be a delay and you might be asked to take a pregnancy test.

According to the NHS, you won't be able to get the implant if you're suffering or have suffered from liver disease, unexplained bleeding from the vagina, cancer of the reproductive organs, heart attacks, strokes or if you could be pregnant.

period pain

Pros and cons

Here's a couple of pros and cons to having the implant.

Pros

  • The implant is very effective, at over 99% pregnancy prevention
  • You don't have to remember to do anything, e.g. take pills or get it changed often
  • It does not interfere with sex
  • It's good for those who can’t take oestrogen
  • It can be removed if you have trouble with it
  • Does not interfere with fertility - you can get pregnant right after removal
  • It can offer protection against pelvic inflammatory disease.

Cons

  • Usually interferes with your periods - you could have irregular bleeding, no bleeding at all, or prolonged bleeding for a while
  • Side effects include headaches, spots, dizziness, weight gain, sore boobies, mood swings
  • Very rarely, infection in the site
  • It can be difficult to remove (although there are minimal cases of migration)
  • No STI protection.

Experience #1: 22 year old female, two years in

 

I went to the doctor and asked for the implant, so he referred me to a GUM clinic and I had a consultation. A week later I had the appointment for my implant. I'd previously been on the pill and felt I needed something more long-term.

You lie down, the doctor or nurse makes a mark and then numbs the area with the anaesthetic. I wasn't looking, but it felt like she injected a bit, moved it out, injected a bit, moved it out and I just jabbered about anything the whole time she was doing it. Then she went to get the Implanon thing. It looks a bit like a pregnancy test. Again, I only briefly looked at it. It's long and thin and the means of inserting it and the implant are all one thing. You don't feel pain, only pressure. The needle goes in (pressure, not pain) and then *click* and the implant is in, and the needle thing gets taken out. She then lets you have a bit of a poke and bandages you up and sends you on your way.

For pain, they use local anaesthetic to put it in. It doesn't hurt at all. When the anaesthetic wears off a few hours later it aches. My arm hurt for a couple of days. Now I can't even see where it went in, or feel it unless I wiggle around and try to find it. Poking a stick out of my arm is quite the party piece. I dread to think of how much it'll hurt when it comes to cutting out the bit of plastic which has probably grafted onto fat tissue in my body.

And how is it going? Well, I had one normal period and then 3 days extra straight afterwards and have had nothing since (NB that this isn't the case for everyone). It's brilliant not having periods, no mess, no fuss and you can have sex whenever you want. Recently I've been a bit moody but I think I might be blaming it on the implant when it's just the stress of term, interviews etc. Am very happy with it and totally pleased I got it put in. Before I did used to worry if I was taking the pill properly (even though I was) but now it's a weight off my mind and I can just get up and go and don't have to remember to take my pills when I go away.

I haven't had a period since it was put in 2 years ago but that varies a lot from person to person. I'd never had spotting on the pill or anything so maybe my body works well with artificial hormones? My side effects are mainly mood swings, definitely for me. But nothing else.

Experience #2: 18 Year old female, seven months in

 

I did some research on the internet about it. Found some forums and asked questions. I phoned straight up to my local 'Women's Clinic' (what they call it here), asked if they did it and booked an appointment (I first called a sexual health clinic and they didn't do it). I had to say what it was about (so the doctor would vaguely know what that appointment entailed).

Came the appointment day and I thought this was just for a consultation. I first went in and spoke to a nurse who took my medical history (a few questions, took 5 minutes). Then I waited for the doctor. The doctor suggested I go on a POP before I had the implant in, because I was on a combined pill at the time. You do not have to do this, I just said 'No thanks' and they were fine. Then the doctor asked me if I wanted it in there and then, I said sure. I'd bee taking my pill up until the night before, but she said that was OK, but use another method of contraception for 1 week.

The doctor asked me which arm I'd prefer it in, and I said left. I opted not to have a local anaesthetic because I didn't want the aching and bruising. It goes about the same as the experience above, she pushed it in, took all of 30 seconds and to be honest, it didn't hurt at all as it was numb. I just didn't look. Afterwards, she let me poke it, to find out where it is, and then put on a pressure bandage.

She filled out a little credit card type thing that had come with the implanon in the box which basically says where it is and when you need to change it. I think the idea is that you carry it around, which could be useful in the event of an accident, I suppose.

Afterwards, it ached a bit. I've had 2 periods in the seven months. They were both very light and lasted about a week. I have a tiny spot-like scar on my arm, which is quite useful when you want to find where the implant is and isn't noticeable at all.

The only side effect that I MAY have, is blocked sinuses. I've had sinusitis since 2 months after it was put in, I am not sure if the implanon caused it or not, but I feel I should put it down here.

Experience #3: 20 year old female, getting it replaced

 

I had become a bit distressed about my constant bleeding after two years on Implanon. The family planning doctor reassured me greatly and ran through my options - coming off contraception altogether, persevering, getting a new implant etc etc.

When it was decided that we were going to replace my implant early, she let me lie down on the little bed and got me to look away and hold my arm out.

I got a good dose of local (which hurt less than the "putting it in session") and she chatted about..oh, I don't know, I was too concerned with the scalpel.

Then, when I was numbed, she started to test me with poking me with her finger, then the needle and asking me if I could feel it. I could feel nothing at all so she proceeded to cut a .5cm slit just under where my implant is (right by the insertion scar). Obviously, bit of blood here. No big deal.

The next minute, I could feel a slight tug, and she was rootling around with some mosquito forceps, which were tiny, couldn't feel a thing. She was gradually easing the implant out as my skin had become quite attached to it.

She was being as gentle as possible and thus it took about five minutes to free it. After she got it out, she simply whacked the new one into the same place - so no extra scarring. Voila! Bandaged up and off I went. No big deal at all.

The scar was little, linear and red. Now it has pretty much calmed to the extent that you struggle to see it. No pain has been felt at all apart from a little bit of itching and the new one settled just as the old one did.

Now, four months later the scar has gone white and gives me no trouble at all. Nobody has even noticed it's there.

Experience #4: 18 year old female, six months in

 

I had very severe, heavy, painful periods which made me nauseous, and unable to do anything without the assistance of a hot water bottle. After I had to sit an exam the next day because of them - plus started seeing my boyfriend - I decided I had to get some contraception.

I went on Microgynon, which was actually a very good contraceptive for me (I wasn't experiencing any negative side effects to my knowledge) and was on that for about 4 or 5 months. However, I still didn't like having periods (even on Microgynon, although improved, they were quite heavy and uncomfortable), so I took packets back to back for most of the time. I started to get a little worried about this habit, and a little worried about missing pills. My memory is terrible so I had to have this loud phone alarm to remind me to take it every day - which was irritating, and still would miss one now and again - which was disruptive to my sex life.

I think I heard of the implant when I went to get Microgynon for the first time from my GP - they are eager to get women on it because it is more effective against pregnancy (as people forget to take pills). So when I went to uni, I made an appointment with the GP there and decided to talk about getting one.

I had one appointment to discuss the implant and decide that I wanted it. I was given leaflets and so on. I had to wait until I was on my period to have it put in though - because they don't want to go putting one in a pregnant girl. The procedure itself was actually really good. I expected it to be much more painful than it was. You have the local anaesthetic and then a few minutes later they test to see if you have any sensation before going ahead. Having the little rod inserted was kind of odd feeling but not really painful. It hurt a little bit at the end, but I'd say the whole thing was less painful than your average injection. It goes into the underside of your arm (kind of). I think this is why it doesn't hurt so much because the tissue there (even in a slim person) is mostly skin and fat, not muscle. I did get a massive bruise, and my arm was achey for a while after (but not excessively so). The site of the implant didn't hurt especially. It would have bled I expect, but you have a big bandage put on it.

I was on my period at the time... but it didn't end. It did peter out to a kind of very thin/painless period but this kind of "end of period" bleeding then continued for about 2 weeks. I left it until I decided to just take Microgynon so that it would go away. And from then on I used Microgynon to control things when I wanted to. For about 3/4 months, whenever I didn't take Microgynon I bled almost continuously (it might go away for 3 days then come back). I think it's quite possible that interfering with Microgynon (mostly because my bf was visiting and I didn't want to be bleeding) may have prevented the implant from settling down.

About 2 months ago I decided to just stop taking Microgynon altogether and allow the implant time to settle (I had 6 weeks with no boyfriend around), and things do seem to finally be settling and getting better. I don't really have any "proper" periods anymore - if there is proper bleeding it will only last about a day, and so will any pain I have. I do not suffer the pain and debilitation I did a year ago so on that front I am really pleased. I also don't have to take a pill everyday anymore.

As it is, currently, my pattern seems to be an extremely light "period" lasting about 5 or 6 days before it clears up. It's not very messy, not painful, doesn't require anything more than just thin liner, and I can still have intercourse. I have one about every 2 weeks. The length of the average period does appear to be shortening, and the interval between periods appears to be getting longer. So hopefully they will eventually just peter out altogether.

I don't feel I need to go back on Microgynon to control it now, and I'm not going to have the implant out. I am definitely better off than when I had no hormonal contraceptive, but maybe that's because I had it particularly bad. On Microgynon I had more control, but the periods I chose to have were heavier and more painful, and the risk of missing a pill and falling pregnant is too much for me. I haven't experienced any noticeable side-effects other than the irregular bleeding.

Experience #5: 21 year old female, 10 months in

 

I decided that I needed to get another form of long-term contraception rather than relying on other methods. I booked an appointment and printed off some information to read about the Implant. Went in and discussed it and then booked a date when my period should arrive. Went in on that day and got it put in.

I had an injection of local anesthetic and made sure I wasn't looking when they injected it in. Could only feel the pressure of it being injected into my arm. Got a nice bandage around my arm and it was a little sore after the anesthetic wore off. Sported a nice bruise too for a while.

About a week after it being inserted I had the worst period of my life for about 10 days. I think I had every side effect that's listed for it; achey breasts, mood swings, major stomach cramps every day, and even a few heart pains which can apparently happen. However, since that 10 day period I didn't have anything for months until a couple of months a go where I went through a 3 week period of having a weekly 1 day period. Since then I haven't bled at all, though carry emergency supplies just in case. Coming up to the anniversary of my receiving my implant and I can honestly say it's been worth it - just for the peace of mind and the bonus of having pretty much no bleeding at all.

Experience #6: 19 year old female, no longer have it

 

I decided I wanted something long-term as I was sick of always worrying about being pregnant even though I used condoms. So I went for a consultation at my sexual health clinic at college and the next week I was due to have it fitted.

It wasn't too bad getting it done as my arm was numbed first, although I could feel the rod being pushed in which wasn't pleasant for me. No plasters for me since I am allergic, so I got a nice bandage instead. There was some bruising on my arm and I could feel the rod in my arm from time to time, but nothing serious.

I was one of the unlucky ones. I had a constant period for 3 months, came off for 2 and then back on for 3 months again. I had no pain at all but my mood swings were terrible; I was so mean and it affected me particularly badly since I felt unhinged the whole time I was on it. I'm glad I tried it but I wouldn't have it again. I no longer have the implant.

Experience #7: 23 year old female, 18 months in

 

I had just recently given birth and did not want to get pregnant anytime soon. I have already been on the depo shot for four years prior. I am not good at taking the pills every day at the same time, so my doctor and I discussed the implanon rod.

A doctor who specialized in putting the rods in performed my procedure. Unfortunately, it was not a good one. She numbed me with anesthetic three times and I could still feel everything. And I do mean everything. I've heard it's suppose to be slit, wham, and bam you're done! Nope! She couldn't get it to go in properly. This took an antagonizing hour to put this rod into my arm. An hour. It really was horrifying.

It's 18 months later. Shortly, after I had gotten the rod put in, I wound up pregnant and had a miscarriage. We were really careful, but I had been put on some antibiotics, and we forgot that it cancels each other out, so it was our fault on that account, but not so sure on the miscarriage. I haven't been bleeding much, but I recently been having some mood swings, and I usually get migraines from time to time, about 5-10 every month, and now they're absolutely horrendous. I have gained a lot of weight. I'm having really bad problems with my vision. the site where the rod is itches every day and pulls on something, not quite sure if it is muscles or veins, but its hurts. Recently, I have been having the pain go to my armpit. It is on my left side. Will be calling doctor to see what we can do. I will not be replacing this.

Have you had the implant fitted? Any advice to share? Join in with the conversation below.

Related on TSR:

Getting the coil fitted

All about smear tests

The lowdown on contraception