What is the contraceptive implant?

The contraceptive implant, Nexplanon, is a small flexible plastic rod that is placed under the skin in your upper arm by a nurse or doctor. It releases the hormone progestogen into your bloodstream to prevent pregnancy. A contraceptive implant can last for 3 years.

What does the implant look like?

The contraceptive implant is a small flexible plastic rod that is inserted under the skin of your upper arm.

How big is the implant?

The contraceptive implant is about 4cm long and roughly the size of a matchstick.

What brands of the implant are there?

Nexplanon is the only contraceptive implant available on the UK market.

How does the implant work?

The implant gradually releases the hormone progestogen into your bloodstream. This prevents the release of an egg each month (ovulation). Progesterone also thickens the cervical mucus making it harder for sperm to move through the cervix. It also thins the lining of the womb which makes it less likely for a fertilised egg to implant itself.

How long does it take for the implant to work?

If you have regular periods and have the implant fitted in the first 5 days of your menstrual cycle, you will be immediately protected from becoming pregnant. If the implant is fitted on any other day of your menstrual cycle, you will need to use additional contraception (like condoms) for 7 days.

How long does the implant last?

The implant lasts for 3 years. This means once you have it inserted, you do not have to think about it again for 3 years unless you experience side effects or complications.

How effective is the implant?

The implant is more than 99% effective at preventing pregnancy, butit does not protect you from getting an STI (sexually transmitted infection), so you may need to use condoms too.

Can you get pregnant on the implant?

The implant is more than 99% effective. This means fewer than 1 out of 100 people who have the implant will get pregnant each year.

How is the implant fitted?

To have the implant fitted, a local anaesthetic is used to numb the area on the inside of your upper arm. The implant can then be inserted under your skin. It usually only takes a matter of minutes to put in. You will not need any stitches once your implant has been fitted.

Does the implant hurt?

When you have the implant fitted, it feels like having an injection. You should only feel a little pinch or stinging when a doctor or nurse fits it.

How long does it take to get the implant fitted?

It usually only takes a few minutes to put the implant in. This includes having a local anaesthetic to numb the area the implant is being inserted into.

Can I get the implant at home?

No. Only a nurse or doctor can fit an implant. You can have the implant fitted at a contraception clinic, sexual health clinic, GUM (genitourinary medicine) clinic, and some young people’s services. Some GPs or practice nurses can fit and remove the implant, so you will need to check at your GP surgery. Otherwise, most sexual health clinics can fit the implant for you.

How is the implant removed?

The implant can be taken out at any time. However, it must only be done by a specially trained nurse or doctor. A medical professional will make a small cut in your skin so the implant can be gently pulled out. The process from start to finish usually takes a few minutes. Rarely, it can be difficult to remove and in this case, you may be referred to another doctor to have this done. 

Once your implant has been removed, you will no longer be protected against pregnancy.

Where can I get my implant removed?

You can have the implant removed for free at a contraception clinic, sexual health or GUM clinic, and some young people’s services. Not every GP or practice nurse can remove the implant, so you will need to contact your GP surgery to check. Most sexual health clinics can remove the implant for you.

Can I remove the implant at home?

No. Only a medical professional like a nurse or doctor can remove the implant. There are several ways you can get the implant removed as shown above.

What to expect after having the implant removed

When you have the implant removed, you may feel a little sore after the anaesthesia has worn off. There may be some bruising in the area that may last for a couple of weeks.

You can have the implant removed at any time. Once this happens, you will no longer be protected from pregnancy

How long after implant removal will I start my period?

Most women return to their normal menstrual cycle within a month of having the implant removed. If you have any concerns, you should speak to your doctor for advice.

How soon after implant removal will I ovulate?

It can take up to 6 weeks for fertility to return after having the implant removed though pregnancies have been reported within the first 2 weeks.

What are the advantages and disadvantages of the implant?

It must be noted that there are several advantages and disadvantages linked with having the implant fitted.

Some of the advantages of the implant include:

• it can work for 3 years
• it does not interrupt sex
•  it is an option if you cannot use oestrogen-based contraception, like the combined contraceptive pill
• it is safe to use while you breastfeed
• your fertility will return to normal once the implant is removed
• it may reduce period pain or heavy periods
• it is very useful for women who have difficulty remembering to take a contraceptive pill at the same time each day

Some of the disadvantages of the implant include:

you may get temporary side effects for the first few months, like nausea, headaches, and tender breasts

• your periods may stop altogether or be irregular
• you may get acne, or your acne may get worse
• you will need a small procedure to have the implant fitted and taken out
• it does not protect you against STIs so you may need to use condoms too

What does the implant do to periods?

When you have the implant fitted, vaginal bleeding may become lighter, irregular, longer, or heavier than normal. A common side effect of the implant is that your periods stop (amenorrhoea). Although this is not harmful, you may wish to consider this before deciding to have the implant fitted.

Does the implant cause acne?

The implant can cause acne. If you have acne before getting the implant fitted, you may find it gets worse over time. If this happens you can speak to your GP about using acne treatment.

Does the implant cause weight gain?

The implant does not cause weight gain. Though it’s listed as a potential side effect by the manufacturers, more recent studies have found that the implant isn’t associated with weight gain. 

Does the implant cause migraines?

You may get temporary side effects during the first couple of months of having the implant fitted. These can include headaches and more rarely, migraines. If you develop migraine symptoms you should speak to your GP to confirm the diagnosis and check for any other causes.

Risks of the implant

In rare instances, the area of skin where your implant is fitted can become infected. If this happens, you may need to get antibiotics to treat it.

You must see your doctor or healthcare professional if:

• you cannot feel the implant
• the implant feels like it has changed shape
• you spot any changes to your skin or feel pain at the site where the implant is
• you become pregnant
• you develop any serious side effects

Some medicines can make the implant less effective. These include:

• some medicines for epilepsy and HIV
• some antibiotics, like rifampicin and rifabutin, commonly used to treat TB
• some antifungal medicines
• complementary remedies, like St John’s Wort
• ellaOne, one of the emergency contraception pills

If you are taking any medication you should always tell the health professional inserting your implant. If you start any new medications always check with the prescriber or your pharmacist whether this will affect your implant. They can let you know how long you will need to use additional contraception like condoms. Alternatively, you may choose to use a different form of contraception that is not affected by your medicine.

Who can use the implant?

Most women can have the implant fitted. However, it may not be suitable if you:

• think you may be pregnant
• do not want your periods to change
• take other medicines that can affect the implant
• have unexplained bleeding after sex or in between periods
• have breast cancer or have had it previously
• have certain liver diseases
• Develop a heart disease or a stroke whilst using the implant
• have a medical condition that might affect which contraception you can use

You can have the implant fitted any time after you have given birth. If the implant is fitted before day 21 after the birth, you will have immediate protection against getting pregnant. If the implant is fitted on day 21 or after, you will need to use additional contraception, like condoms, for the following 7 days.

How to get the implant

There are several options available to you if you would like to get the implant. These include visiting a sexual health clinic or visiting your GP surgery. You should check with your GP surgery receptionist if this service is available at your surgery.

Can I get the implant on the NHS?

Yes. You can get the implant for free, even if you are under 16.

Can I get the implant privately?

Yes. You can have the implant fitted privately. However, you will need to check with your clinic to make sure they provide this service.

Where to get the contraceptive implant near me

You can use the NHS website to find the nearest sexual health clinic near you. Most will fit and remove the implant for you. Alternatively, make an appointment with your GP as they may be able to offer this service.

How much does the implant cost?

The implant is available for free on the NHS. If you are thinking of getting an implant, you should speak to your GP. They will determine whether you can have one fitted.

Sources

• Contraceptive implant (March 2021) NHS (Accessed 14 March 2022)
• Contraceptive implant (November 2020) Sexwise (Accessed 14 March 2022)
• Find Sexual health information and support services (March 2022) NHS (Accessed 14 March 2022)
• Nexplanon 68 mg implant for subdermal use – Patient information leaflet (PIL) (October 2021) EMC (Accessed 14 March 2022)
• Nexplanon: Removing Your Implant (April 2021) WebMD (Accessed 14 March 2022)
• The different types of contraception (March 2022) NHS Inform (Accessed 14 March 2022)
• Where can I get contraception? (April 2021) NHS (Accessed 14 March 2022)
• file:///Users/drclairgrainger/Downloads/fsrh-guidance-drug-interactions-hormonal-contraception-jan-2019%20(13).pdf (accessed 21/3/22)
• file:///Users/drclairgrainger/Downloads/fsrh-ukmec-summary-september-2019%20(15).pdf (accessed 21/3/22)
• file:///Users/drclairgrainger/Downloads/2fsrh-guideline-progestogen-only-implant-feb-2021.pdf (accessed 21/3/22)