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A woman can get pregnant if a man’s sperm reaches one of her eggs (ova). Contraception tries to stop this happening by keeping the egg and sperm apart or by stopping egg production. One method is the implant.
The contraceptive implant is a small flexible tube about 40mm long that’s inserted under the skin of your upper arm. It’s inserted by a trained professional, such as a doctor, and lasts for three years.
The implant stops the release of an egg from the ovary by slowly releasing progestogen into your body. Progestogen also thickens the cervical mucus and thins the womb lining. This makes it harder for sperm to move through your cervix, and less likely for your womb to accept a fertilised egg.
The implant steadily releases the hormone progestogen into your bloodstream. Progestogen is similar to the natural hormone progesterone, which is released by a woman’s ovaries during her period.
The continuous release of progestogen:
The implant can be put in at any time during your menstrual cycle, as long as you and your doctor are reasonably sure you are not pregnant.
Nexplanon is a small, thin, flexible tube about 4cm long. It is implanted under the skin of your upper arm by a doctor or nurse. A local anaesthetic is used to numb the area. The small wound made in your arm is closed with a dressing and does not need stitches.
Nexplanon works for up to three years before it needs to be replaced. You can continue to use it until you reach the menopause, when a woman’s monthly periods stop (at around 52 years of age). The implant can be removed at any time by a specially trained doctor or nurse. It only takes a few minutes to remove, using a local anaesthetic.
As soon as the implant has been removed, you will no longer be protected against pregnancy.
If the implant is fitted during the first five days of your menstrual cycle, you will be immediately protected against becoming pregnant. If it is fitted on any other day of your menstrual cycle, you will not be protected against pregnancy for up to seven days, and should use another method, such as condoms.
You can have the contraceptive implant fitted after you have given birth, usually after three weeks.
It is safe to use the implant while you are breastfeeding.
The implant can be fitted immediately after a miscarriage or an abortion, and you will be protected against pregnancy straight away.
Most women can be fitted with the contraceptive implant.
It may not be suitable if you:
The main advantages of the contraceptive implant are:
Using a contraceptive implant may have some disadvantages, which you should consider carefully before deciding on the right method of contraception for you. These include:
Your periods may change significantly while using a contraceptive implant. Around 20% of women using the implant will have no bleeding, and almost 50% will have infrequent or prolonged bleeding. Bleeding patterns are likely to remain irregular, although they may settle down after the first year.
Although these changes are not harmful, they may not be acceptable for some women. Your GP may be able to help by providing additional medication if you have prolonged bleeding.
Side effects that some women report are:
These side effects usually stop after the first few months. If you have prolonged or severe headaches or other side effects, tell your doctor.
Some women put on weight while using the implant, but there is no evidence to show that the implant causes weight gain.
Some medicines can reduce the implant’s effectiveness. These include:
These are called enzyme-inducing drugs. If you are using these medicines for a short while (for example, rifampicin to protect against meningitis), it is recommended that you use additional contraception during the course of treatment and for 28 days afterwards. The additional contraception could be condoms, or a single dose of the contraceptive injection. The implant can remain in place if you have the injection.
Women taking enzyme-inducing drugs in the long term may wish to consider using a method of contraception that isn’t affected by their medication.
Always tell your doctor that you are using an implant if you are prescribed any medicines. Ask your doctor or nurse for more details about the implant and other medication.
In rare cases, the area of skin where the implant has been fitted can become infected. If this happens, the area will be cleaned and may be treated with antibiotics.