Wondering which type of contraception is right for you? The good news is there are plenty of options to choose from, from condoms to the contraceptive pill. But one birth control method you might not know as much about is the implant.
Recent stats published by the Centers for Disease Control and Prevention (CDC) show the implant is not the most popular form of birth control: just 10.4% of women in the United States aged 15–49 surveyed who use birth control have the implant or an IUD (coil), whereas 14% use the pill, and 18.1% have been sterilized.
But the implant is definitely worth considering. It’s 99% effective, quickly reversible, and lasts three years. It can take the stress out of family planning, especially as you don’t have to remember to take a pill every day!
Below, we’ve pulled together an expert guide to the birth control implant. Read on to find out how it works, how effective it is, and where to get it fitted.
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The birth control implant (aka Nexplanon) is a small, flexible plastic rod that looks a bit like a matchstick. It’s inserted just under the skin on the inside of your upper arm by a health care professional and releases hormones directly into your bloodstream to prevent unplanned pregnancy.
Like an IUD, the birth control implant is labeled as a long-acting reversible contraceptive (LARC) or “fit and forget” method. That means you can have the arm implant inserted and don’t have to worry about contraception again for around three years. After that, it’ll need to be removed and replaced.
That said – if for any reason you change your mind, experience side effects, or aren’t happy with the implant – you don’t have to wait until the three years are up. Your medical professional can remove it immediately. Then, if you want to get pregnant, you can start trying for a baby right away. In fact, 90% of women find their period returns within 90 days of having the implant removed.
The birth control implant might be small, but it’s a hard-working piece of equipment! It works by releasing etonogestrel, a synthetic version of the hormone progestin that prevents 99% of unplanned pregnancies. Progestin does this in three ways:
- Thickening your cervical mucus to make it harder for sperm to swim into the cervix
- Stopping ovulation so there’s no egg for the sperm to fertilize
- Altering the lining of the uterus to stop a fertilized egg from successfully implanting
Remember though that the birth control arm implant doesn’t protect you from catching a sexually transmitted infection (STI), so always use a barrier method, like condoms, if you’re unsure of your partner’s sexual health status.
Booking an appointment with your doctor is the best place to start when trying to figure out which method of contraception is right for you. They’ll be able to help you weigh everything up based on your personal circumstances and medical history.
There are lots of advantages to the birth control implant, including:
- Effectiveness: Like the contraceptive pill, implants are 99% effective, meaning fewer than 1 in 100 women using the implant will get pregnant in a year. However, unlike the pill, which relies on “perfect use” (taking it at the same time every day), the implant doesn’t require any attention from you to work effectively.
- Convenience: Implants are a long-term (three-year) method of contraception, so you’re protected without having to remember to take a pill daily. Once the implant is inserted, you can forget about contraception until it’s removed.
- Positive menstrual cycle effects: Some women report a lighter period while using the implant. This makes it a good type of contraception for those of us who experience heavy, painful periods.
- Less hormones: Can’t take estrogen-based contraceptive methods like the contraceptive pill, patch, or vaginal ring due to migraines or nausea? Implants are a progestin-only form of birth control.
- Future fertility: The birth control implant is not known to have any effect on future fertility, and it’s possible to begin trying for a baby immediately after it’s removed.
As with any medical device or medication, there are always potential disadvantages and side effects. While these are unlikely to affect everyone, it’s important to be aware of them so you can make an informed decision before scheduling an appointment to have an implant fitted. These include:
- No protection from STIs: The implant is designed to protect you from unplanned pregnancy — not sexually transmitted infections — so make sure you use a barrier method, such as condoms, if you’re unsure of your partner’s sexual health status.
- Medicines and effectiveness: Some medications can make the implant less effective at preventing unplanned pregnancy. They include anticonvulsants (carbamazepin, oxcarbazepine, and others), antifungals (griseofulvin), a form of vitamin A (acitretin), and others. Check with your doctor about any medication you’re currently taking.
The patient information leaflet provided with the implant lists the following most common reported side effects, taken from clinical trials:
- Headache
- Irregular bleeding and a shorter period
- Weight gain
- Mood swings
- Depression (although this is rare, affecting 1% of those who took part in clinical trials)
- Acne (again less common — just 1.3% reported this side effect)
Please note this list is not exhaustive. Remember that medication side effects vary from person to person, and not everyone will experience them. Speak to your health care provider if you have any concerns or questions.
You’re probably wondering what it’s like to get a birth control implant inserted – and you’re not alone. “How painful is the birth control implant?” is one of Google’s most asked questions!
Before we answer that, let’s look at what happens when you schedule an appointment to have a birth control arm implant fitted at your usual healthcare provider, local Planned Parenthood health center, or by another nurse or doctor.
First up, your health care professional will talk to you about your general health. Don’t be surprised if they ask questions about your medical history, including your cycle. This is to make sure the implant is the right form of contraception for you. They’ll also discuss any previous methods of birth control you’ve tried, and you might need to take a pregnancy test before the implant is inserted.
The procedure itself doesn’t take long — and shouldn’t be too painful either. You’ll lie down while your health care provider locates the space between your bicep and tricep muscle on your inner upper arm. They’ll inject some local anesthetic to numb the area (and stop it from feeling too painful). Then they’ll use an applicator to insert the implant just beneath your skin.
Your doctor will determine if the implant is in the right place by feel, and, if needed, they can also use ultrasound or an X-ray to ensure that the location is correct. Then they’ll cover the area with a bandage, which you can remove after 24 hours.
You can have the implant fitted at any time during your menstrual cycle, as long as you aren’t pregnant. However, bear in mind that it might be worth scheduling your insertion during the first 5 days of your cycle because then you’ll be immediately protected against unplanned pregnancy.
If it’s inserted on any other day of your cycle, then you’ll need to use a back-up method of contraception for seven days (until the implant starts working).
You can also have the implant inserted after you have given birth — it’s safe to use while breastfeeding. Again, timing matters here. If you have it inserted sooner than 21 days after giving birth, then you’re immediately protected from unplanned pregnancy. If it’s inserted any time after this, you’ll need to use an additional method of contraception for seven days. Check with your doctor if you’re unsure.
Just like having the birth control implant inserted, you’ll need to schedule an appointment with your health care provider to have your implant removed safely.
Removing the birth control implant is quick and straightforward, and the procedure takes around 5 minutes from start to finish. Again, they’ll numb the area with an anesthetic before making a small cut and gently pulling the implant out of your arm. The implant stops working as soon as it’s removed, so remember to switch to another type of birth control if you’re not planning to get pregnant.
The cost of the birth control implant depends on where you live. In the U.K, for example, the implant is free on the NHS. In the United States, it can cost up to $1,300; however it is often covered under most health insurance plans, Medicaid, and other government programs. Ask your health care provider for more information.
No birth control method is perfect, but if you want to spend less time thinking about contraception or remembering to take a pill on time, then a birth control implant can be an excellent choice. Remember, though, implants won’t protect you from STIs, so make sure you use condoms if you’re unsure of your partner’s sexual health status.
Implants are a long-term and extremely effective contraception method with minimal risk. If you feel an implant could be the right choice for you and your lifestyle, book an appointment with your doctor or health care professional to discuss your options.