• The Contraceptive Implant

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The Contraceptive Implant

The implant has been met with heavy scepticism, with one type even being taken off the listing because it caused so much scarring. This is Norplant. Some of you might still have it in, but it’s been discontinued in the UK.

The main type now is Implanon. It’s a small, flexible tube that is about the same size as a Kirby grip, containing progestogen. It releases it steadily into the bloodstream from the comfiness of your upper arm. It lasts for three years. [Norplant for 5].

It basically does what most contraceptives in the body do; thicken mucus around your cervix, thins your uterine lining and also prevents egg release [and therefore bleeds, in time]

When it is put in [usually first day of period], you are likely to be given a local anaesthetic, then have the implant injected. You will probably be bruised and sore for a few days. You’ll be able to feel and fiddle with it, but resist that temptation for a while! You will be protected from the word go (if it's inserted in the first 5 days of your cycle. If not, you'll have to have protected sex for a week before contraceptive implant protects you from pregnancy)!

When you’re getting it removed, it is cut out. 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 lost protection as soon as the implant is taken out.

You ought to have a check up after the first three months, then just once a year providing you’re not having problems.

SMALL EDIT: Implanon has now been discontinued, and nexplanon is what is currently being given out now.

The Good Stuff

• The implant really is the most effective form, at over 99% pregnancy prevention • It’s not like you have to remember to do anything! • It does not interfere with sex. • You still breastfeed • It is good for those who can’t take oestrogen for whatever reason • It can be removed if you have trouble with it, and you can get pregnant right after removal • It offers protection against pelvic inflammatory disease.

The Bad Side

• It can go a few ways; you could have irregular bleeding, no bleeding at all, or prolonged bleeding for a while. This is annoying, but it can’t harm you • Your usual headaches, spots, dizziness, weight gain, sore boobies, mood swings • Very rarely, infection in the site • It can be difficult to remove. There have only been 2 or 3 cases of migration, though • Harmless ovarian cysts, with a little pelvic pain • Mood swings • No STI protection [duh]

Don’t get it if you are suffering or have suffered from • Liver disease • Unexplained bleeding from the vagina • Cancer of the reproductive organs • Heart attacks or strokes Or if you could be pregnant

Can I have it?

The only person who can tell you is 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. Some older doctors might be less enthusiastic about giving you the implant (these are usually those who aren't as well informed) but longer term contraception is becoming more and more recommended - particularly for younger women.

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.

How is it put in?

  • It goes on the upper underside of your arm, somewhere between your armpit and elbow.
Insertion point for Implanon
  • Your arm is usually numbed by local anaesthetic
  • A small incision is made
  • The carrier for the Implanon is inserted into your arm. It looks a bit like a pregnancy test with a long needle. The needle part is inserted into your arm.
  • The doctor loads the implant into your arm by clicking the non-needle end of the carrier
  • The carrier is taken out of your arm
  • A dressing is held in place and you're wrapped up - no need for stitches or anything

What if I hate it/have awful side effects?

They encourage you to keep the implant in for 3 months to give it a fair chance. If you have prolonged periods, they can give you the pill on top to keep them at bay (strange I know!) until they settle down. You can have the implant taken out whenever you like but as soon as you have it out you're no longer covered so you need to use other methods immediately (and take precautions if using a method that takes a while to kick in).

Experience: 22 year old female

Before

I went to the doctor and asked for it, 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.

During

You lie down, she 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 needly bit 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.

Pain = they use local anaesthetic to put it in. In itself it doesn't hurt at all. When the anaesthetic wears off a few hours later it aches. My arm hurt for the day and day after. 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.

After

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 it 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.

Periods = haven't had one since it was put in 2 years ago (and no I'm not pregnant) 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?

Side effects = mood swings, definitely for me. Nothing else.

Experience: 18 Year Old Female. 7 Months in and Counting

Before

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).

During

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.

After

Ached a bit.

I've had 2 periods in the 7 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 not 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.

Implanon Removal

Experience: 20 year old female

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 [common, apparently] 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. [Tiny, couldn't feel a thing] and she was gradually easing the implant out. [My skin, it seemed, 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 on 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: 18 Year Old Female. 5/6 Months in

Before

I had had very severe, heavy, painful periods which made me nauseous, and kinda unable to do anything without the assistance of a hot water bottle. Once I had to sit an exam the next day because of them, this combined with the appearance of a boyfriend - I decided I had to get some contraception. I went on microgynon, which was actually a very good contraceptive for me (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 girls on it because it is more effective against pregnancy (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.

During

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.

After

I was on my period, remember. Well that's the thing. 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, however.

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 you see), and things do seem to finally be settling/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 :D As it is, currently, my pattern seems to be an extremely light (not very messy, not painful, don't require anything more than just thin liner, and I can still have intercourse) "period" lasting about 5 or 6 days before it clears up. And 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: 17 Year Old Female, 3 weeks in

Before

I needed to get some sort of contraception, and I didn't fancy relying on taking a pill everyday, as it is something that I could easily forget to do. A couple of my friends had already got the implant so I knew a fair bit about it. After a bit of research I decided to get it, so I rang up my local Sexual Health services, asked to see somebody who could insert Nexplanon (not all GPs or nurses can do it, so make sure you book to see somebody who can).

During

I'm a big wimp when it comes to pain, so I was very nervous. The nurse gave me some local anaesthetic, which felt odd - but hurt considerably less than a vaccine jab does. After this, I decided not to watch the implant being inserted and as I couldn't feel ANYTHING, I didn't even realise when the nurse had finished. It was very quick. It is inserted through a small hole that it made in the skin, so the only scar you will get is a small freckle-sized one. She gave me a large bandage, which I think you are supposed to keep on for a few days to stop bruising. However, the nurse told me I could remove it the next morning (less than 24 hours away) because I had to wear a short-sleeve t-shirt for work.

After

My arm was a little achy the following day, but I managed fine with it. Also, I was scared about having a massive black bruise, but I only got a tiny and very faint bluey-yellow bruise a few days later, that was virtually unnoticeable, and this faded after about 5 days. Now, about 3 weeks after insertion, my arm is a little itchy where the implant was inserted, and apart from that it is fine. I have had no spotting or periods, even though I was due about a week ago.

Experience: 21 Year Old Female, 10 months in

Before

Decided that I needed to get another form of long term contraception rather than relying on other methods. 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.

During

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.

After

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 thats 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: 19 Year Old Female, no longer have it

Before

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

During

Wasnt too bad getting it done as my arm was numbed first although I could feel the rod being pushed in which wasnt pleasant for me, no plasters for me since I am allergic so I got a nice bandage instead, Some bruising on my arm and could feel the rod in my arm from time to time but nothing serious.

After

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: 23 Year Old Female, 18 months

Before

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.

During

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.

After

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.

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