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Contraceptive implant

The contraceptive implant is a small, flexible plastic rod that is placed just under the skin in the upper arm. It releases the hormone progestogen to control your fertility. This is similar to the hormone progesterone that women produce naturally in their ovaries.

Here are some key facts:

  • The contraceptive implant is over 99% effective
  • The contraceptive implant is about 4cm long (about the size of a matchstick or hair pin), and is put under the skin in your upper arm by a doctor or nurse
  • It is a method of long-acting reversible contraception (or LARC) which don’t rely on you remembering to take them
  • Once it is put in, it protects against pregnancy for three years, or until you have it taken out
  • It doesn't protect against sexually transmitted infections (STIs) so you will also need to use condoms

How does the contraceptive implant work?

Pregnancy happens when sperm reaches an egg and fertilises it. The implant works in two ways to interrupt this process:

  • stopping ovulation, thickening the mucus around the cervix, which makes it harder for sperm to get through
  • making the lining of the womb thinner so that a fertilised egg is less likely to implant

The implant is about 4cm long (about the size of a matchstick or hair pin), and is put under the skin in your upper arm by a doctor or nurse. Once it is put in, it protects against pregnancy for three years, or until you have it taken out.

The implant is over 99% effective at preventing pregnancy. This means that less than one woman in 100 will get pregnant in a year.

 

How do I get the contraceptive implant?

The implant needs to be fitted by a doctor or nurse who has been specially trained. It is available free of charge from contraceptive clinics, your GP and Brook. Find your nearest using our find a service tool.

When you go to get the implant, an appointment will typically include:

  • A few questions about your medical and family history, to work out what method would suit you best.
  • You'll discuss other medicines you are taking in case they can make the implant less effective.
  • The doctor or nurse will take your blood pressure and will weigh you.

You will not be required to have an internal or breast examination for the implant. If you decide to go ahead you will discuss when would a suitable time to have it fitted. Some services may be able to fit it at the same appointment, or you may need a second appointment.

After the implant has been fitted you only need to go back if you have any problems or when it needs to be replaced (after three years). 

Contraception and sexual health services such as Brook are free and confidential, including for people under the age of 16. Health professionals work to strict guidelines and won’t tell anyone else about your visit unless they believe you're at serious risk of immediate harm. Find out more about Brook’s confidentiality policy.

How is the contraceptive implant fitted?

The implant is placed just under the skin, in your upper arm. A doctor or nurse will give you a local anaesthetic injection, to numb this part of your arm before they put the implant in. It should only take a few minutes, and you won't need any stitches. The area may be slightly tender for a few days, but the doctor or nurse will put a small dressing on, to protect it and help stop any bruising. 

You can have the implant fitted at any time in your menstrual cycle if you are certain you are not pregnant. If the implant is fitted during the first five days of your period you will be protected from pregnancy immediately. 

If the implant is fitted on any other day of your menstrual cycle, you need to use a barrier method of contraception (such as condoms) for the first seven days. You may also be required to take a pregnancy test after the implant has been fitted. 

Once your arm has healed you will be able to do normal activities and you won't be able to see it. Please be careful not to squeeze or play with the implant because occasionally that can cause the small plastic rod to break.

Nexplanon is the main contraceptive implant currently in use in the UK.

How is the contraceptive implant taken out?

The implant can be left in place for up to three years, or you can have it taken out sooner by a specially trained doctor or nurse.

To take out the implant the doctor or nurse will give you a local anaesthetic and will make a small cut in your skin and gently pull the implant out. You will then have a dressing put on your arm which you should keep on for a few days to reduce bruising and to keep it clean and dry.

If you want to continue using the implant, the new one can be put in at the same time and you will still be protected from pregnancy.

Advantages of the contraceptive implant

  • It doesn’t interrupt sex
  • It works for up to three years
  • It is an option for people who can’t use contraception containing the hormone oestrogen (such as the combined pill, contraceptive patch, or the vaginal ring)
  • There is no evidence that it causes additional weight gain
  • Your fertility returns to normal as soon as it is removed, with no long term effects
  • The implant is not affected by diarrhoea or vomiting (like some methods)
  • It can help reduce heavy periods and reduce period pain

Disadvantages of the contraceptive implant

  • It’s common to experience temporary side effects during the first few months, like headaches, nausea, breast tenderness and mood swings
  • Bleeding patterns may be irregular or stop altogether
  • It can cause or worsen acne
  • It doesn’t protect you against sexually transmitted infections (STIs), so you will need to use a barrier method such as condoms

Implant: top three side effects

In 2015, Brook did an audit of clients who received an implant and who reported side effects. Read the results together with details of our management of irregular bleeding.

What can make the contraceptive implant less effective?

  • The implant must be replaced every three years and must be replaced at the same time, otherwise you will not be protected from pregnancy
  • Some medicines can reduce the effectiveness of the implant, such as those used to treat epilepsy, HIV and TB and the complementary medicine St John's Wort. Commonly used antibiotics do not reduce the effectiveness of the implant, but it is always best to check with the doctor, nurse or pharmacist first
  • If at any time you cannot feel your implant or it appears to have changed shape, or you notice any skin changes or pain around the site of the implant, then visit a doctor or nurse and use condoms until you know that your contraception is definitely protecting you again

How will it affect my periods?

The implant may cause your periods to be irregular, longer or they may stop all together. This usually settles down after the first year of using it. 

However it is also important to check that the bleeding is not due to any other cause, such as a sexually transmitted infection (STI). It is recommended that you discuss any concerns that you may have with your nurse or doctor. They will offer you an STI test and it might be possible to give you additional medication that can help with the bleeding.

Using the contraceptive implant after having a baby

You can have the implant fitted three weeks after giving birth. If the implant is put in on or before day 21 you will be protected against pregnancy straight away. If the implant is put in later than day 21 you will need to use an additional method of contraception for seven days.

The implant does not affect your milk supply and can be used safely while breastfeeding.

Using the contraceptive implant after having an abortion or miscarriage

You can have the implant fitted immediately after a miscarriage or abortion and you will be protected from pregnancy straight away.

Last review: August 2017
Next review: August 2019