Implants

The contraceptive implant is a small flexible tube that is inserted into the skin of the upper arm by a trained professional. It lasts for three years. It slowly releases the hormone progestogen into the body, stopping the release of an egg from the ovary. This hormone also thickens the mucus at the entrance of the womb (making it harder for sperm to move through) and thins the lining of the womb (so that the womb is less likely to accept a fertilised egg). It is more than 99% effective at preventing pregnancy if implanted correctly.

The contraceptive implant can be fitted in most cases. However, it might not be suitable if you:

• Think you might be pregnant.
• Want to keep having regular periods.
• Have bleeding in between periods or after sex.
• Have arterial disease.
• Have a blood clot (thrombosis).
• Have breast cancer or have had in the past.
• Have diabetes.
• Have cirrhosis or liver tumours.
• Are at risk of osteoporosis.

• It works for three years.
• It does not interrupt sex.
• It is an option if you cannot use oestrogen based contraception (for example, the combined contraceptive pill, contraceptive patch or vaginal ring).
• The implant is safe to use while breastfeeding.
• You do not have to remember to take a pill every day.
• Your fertility should return to normal as soon as the implant is removed.
• Implants offer some protection against pelvic inflammatory disease and cancer of the womb.
• The implant may reduce heavy periods or painful periods after the first year of use.
• You should be able to carry out normal activities after the contraceptive implant has been inserted.

• Your periods may change significantly while using the implant. Around 20% 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. Your clinic may be able to help by providing additional medication if you have prolonged bleeding.
• Side effects may include headaches, acne, nausea, breast tenderness, changed in mood and loss of sex drive. These side effects are usually temporary.
• In rare cases, the area of skin where the implant has been fitted may become infected. If this happens, the area will be cleaned and may be treated with antibiotics.
• Some medicines can reduce the implant’s effectiveness including some anti HIV medications, medication for epilepsy, complementary remedies such as St John’s Wort, rifabutin (an antibiotic used to treat TB) and rifampicin (an antibiotic used to treat several conditions including TB and meningitis).