Today there are many contraceptive methods available, and doctors and scientists are constantly developing new, safer and more effective ones. The contraceptive implant is a modern and innovative method of contraception. Who is it for? How long does it work and can every woman use it?
What is a contraceptive implant?
The contraceptive implant is a hormonal, long-lasting and, importantly, reversible method of contraception. It is a subcutaneous implant that contains 68 mg of etonogestrel, which belongs to the progestin group, i.e. steroid hormones. Etonogestrel is a synthetic female hormone and its profile of action is similar to that of progesterone. It is dominant in the second half of the cycle.
In the subcutaneous implant, the active substance is released into the body for three years. The hormone enters the bloodstream through the subcutaneous blood vessels into which it enters directly.
The contraceptive implant is a flexible small rod placed in a special applicator. It is 4 cm long and has a diameter of 2 mm.
Contraceptive implant – who is it for?
The contraceptive implant is a very safe and effective method of contraception. It can be a good solution for women for whom both long-term and high efficacy are very important when choosing a contraceptive method. It is recommended for patients who, for various reasons, do not want or cannot use oral hormonal contraceptives, e.g:
- for hypertension,
- for diabetes,
- smoking cigarettes,
- over the age of 35.
It is worth noting that the contraceptive implant is a convenient method of contraception because of the way it is used. When it is used, the risk of missing a dose is minimised, as is the case with the pill, which is important for its effectiveness.
Contraceptive implant – effectiveness
The effectiveness of contraceptive methods is measured by something called the pearl index. It was developed in 1932 by Raymond Pearl.
It is the ratio of the number of unplanned pregnancies in couples using this method of contraception in a year to the number of monthly cycles, and the result is multiplied by 1200.
If contraception is not used, the figure is 85-90.
In the case of a subcutaneous implant, the Pearl Index is between 0 and 0.3. By comparison, the index value for birth control pills ranges from 0 to 2.18 (depending on the type of pill).
Among all contraceptive methods currently available, the subcutaneous implant shows the highest degree of efficacy after the hormonal IUD.
How long does the contraceptive implant last?
The contraceptive implant is implanted for 3 years. The hormone contained in the implant is released into the body continuously, but at an increasingly lower rate. The etonogestrel suppresses ovulation.
The patient can stop using this method of contraception at any time – the contraceptive implant is a reversible method. If you wish to stop using it, inform the doctor who will be removing the implant from under the skin.
After its removal, a woman can get pregnant fairly quickly – fertility returns in the next full menstrual cycle.
The other implant inserted is a contraceptive continuum. The doctor can put it back in its original place.
How is a contraceptive implant inserted?
The insertion of a contraceptive implant is a relatively simple and virtually painless procedure.
However, it must always be performed aseptically by a qualified doctor who is familiar with the procedure.
The implant is placed under the skin using a special applicator. It is placed on the inside of the non-dominant arm, about 8-10 centimetres above the elbow bend].
Implantation should be carried out between the 1st and 5th day of the cycle if no other contraceptive methods have previously been used. The first day of the cycle is the first day of a woman’s menstrual bleeding.
If a woman switches from an oral contraceptive to an implant, the insertion procedure should be carried out the day after the last active pill, but no later than the day after the last placebo pill or after the last day of a break.
If the previous method was a patch, vaginal or intrauterine system, the implant should be inserted on the day the patch/IUD is removed.
The implant remains invisible under the skin. It can be palpated by hand. It is a very careful method of contraception.
Contraceptive implant – side effects
An important point is that the contraceptive implant does not contain estrogen, which is responsible for most of the side effects of the combined contraceptive pill. This makes it a safe method – the patient does not experience severe side effects during its use.
It should be remembered that, despite its high safety profile, this medicine is not completely indifferent to the body. Women who use it may experience some side effects, but these are much rarer than, for example, in the case of oral hormonal contraception.
The most common ones include:
- changes in bleeding during menstruation (these cannot be predicted before the implant is inserted). These include irregular menstruation (or no menstruation), changes in bleeding intensity and changes in bleeding time;
- vaginal infections ;
- headaches ; _
- pimples ;
- breast tenderness and pain;
- weight gain.
Less common side effects include:
- a reaction at the implantation site;
- depressed mood, nervousness, hot flashes;
- abdominal pain, nausea, flatulence ;
- painful menstruation;
- ovarian cysts;
- increased appetite;
- dizziness;
- flu-like symptoms;
- weight loss;
- hair loss;
- fatigue;
- decreased libido, but to a much lesser extent than with oral contraceptives.
Please note that using a contraceptive implant does not protect you or your partner from sexually transmitted diseases.
Contraceptive implant – contraindications
The contraceptive implant is an alternative for women who cannot use oral hormonal contraceptives, so it can be used by a much wider group of patients. However, there are some contraindications to its use.
These include:
- Hypersensitivity to etonogestrel, the active ingredient in this method of contraception;
- thromboembolism – in this case you should see a doctor;
- suspected or existing hormone-dependent neoplasms;
- bleeding from the genital tract of unclear etiology;
- liver disease, liver tumours;
- pregnancy or suspected pregnancy.