Contraceptive Implant

1 What is a Contraceptive Implant?

Women can consider contraceptive implants for long-term birth control. A contraceptive implant is a flexible plastic rod about the size of a matchstick that is placed under the skin of the upper arm.

It releases a low steady dose of a progestational hormone to thicken the cervical mucus and thin the lining of the uterus (endometrium).Contraceptive implants typically suppress ovulation as well.

One version of contraceptive implant, Implanon, as recently discontinued and replace with Nexplanon (new version).

Nexplanon is radio-opaque, this means it can be seen on X-ray, which is useful for checking the location of the implant.

It is also the only contraceptive implant with Food and Drug Administration approval in the U.S.

2 Reasons for Procedure

Here are the most common reasons to receive contraceptive implants.

Effective and long-term contraception can be achieved by using contraceptive implants. Contraceptive implants have several benefits including being removable at any time, followed by a quick return to fertility.

Eliminating the need to interrupt sex for contraception or seek partner compliance. Providing relief from menstrual pain (dysmenorrhea) and pelvic pain caused by endometriosis.

Contain no estrogen. However, not everyone can use contraceptive implants.

Your health care provider may discourage use of a contraceptive implant if you are:

  • Allergic to any components of the implant.
  • Have had serious blood clots, a heart attack or a stroke
  • Have hepatic tumors or liver disease
  • Have known or suspected breast cancer or a history of breast cancer
  • Have undiagnosed abnormal genital bleeding.

Although the label for Nexplanon says it shouldn't be used by women with a history of blood clots, it isn't clear whether Nexplanon affects the risk of blood clots.

The warning comes from studies of combination birth control pills that contain the same progestin as is used in Nexplanon.

However, the progestin in Nexplanon is a metabolite of desogestrel, which when used in oral contraceptives, appears to be associated with an increased risk of blood clots compared with pills with other formulations.

Once again, it is not clear if this risk would be significant when the progestin is used alone as in Nexplanon, as opposed to when it's used with estrogen in an oral contraceptive.

In addition, tell your health care provider if you have a history of:

  • An allergic reaction to anesthetics or antiseptics
  • Depression
  • Diabetes
  • Gallbladder disease
  • High blood pressure
  • High cholesterol or high triglycerides
  • Seizures or epilepsy

Nexplanon isn't contraindicated for use in overweight women. However, it's possible the device may not be as effective in women with a body mass index (BMI) above 30.

Certain medications and herbal products may decrease the levels of progestin in your blood, which can decrease the contraceptive implant's effectiveness.

Medications known to interact with the contraceptive implant include some seizure medications, certain sedatives, some HIV medications, as well as the herb St. John's wort.

Talk with your doctor about your contraceptive options if you take any of these medications.

3 Potential Risks

Along with undergoing contraceptive implant procedure comes potential risks.

Nexplanon will not protect you against any sexually transmitted infection (STIs). Far less than 1 out of 100 women who use Nexplanon for one year will get pregnant.

However, if you get pregnant while using a contraceptive implant, the pregnancy might be ectopic, a condition in which the fertilized eggs implants outside the uterus, usually in the fallopian tube.

However, because a contraceptive implant prevents most pregnancies, women who use it have a lowered risk of having an ectopic pregnancy than other sexually active women who are not using contraception.

Side effects of using contraceptive implants may include the following:

  • Abdominal or back pain.
  • An increased risk of non-cancerous ovarian cysts.
  • Decreased sex drive.
  • Dizziness.
  • Headaches.
  • Weight gain.
  • Sore breast.
  • Vaginal inflammation or dryness.
  • Nausea or upset stomach.
  • Potential integration with other medications.
  • Mild insulin resistance.
  • Mood swings and depression.
  • An increased risk of noncancerous ovarian cysts.

4 Preparing for your Procedure

In order to prepare for the procedure, your doctor will make an evaluation of your health and do a pelvic exam before inserting the contraceptive implant.

An appropriate timing for the insertion will be determined based on your menstrual cycle and your previous birth control method.

You may also have to take a pregnancy test and use a nonhormonal method of contraception for a week.

A backup method of contraception may not be necessary if in the following cases:

  • If you previously use no contraception and have Nexplanon inserted during the first five days of your menstrual cycle, even if you are still bleeding.
  • If you have previously used combination birth control pills, a vaginal ring (NuvaRing) or a patch (OrthEvra) for birth control and have Nexplanon inserted within seven days of the start of your hormone-free period.
  • If you have previously used the mini pill and have Nexplanon inserted while taking active pills.
  • If you have previously used a contraceptive injection (DepoProvera) and have Nexplanon inserted the day our next injection is due.
  • If you have previously used Implanon or an intrauterine device (IUD) and have Nexplanon inserted the ay your previous device is removed.

5 What to Expect

Here’s what you can expect before, during, and after your contraceptive implant procedure.

Nexplanon insertion typically takes just a minute or so to complete, though preparation will take a little longer. This procedure is typically done in the doctor's office.

During the procedure. You will lie on your back with the arm that will receive the implant bent at the elbow and positioned close to your head.

You doctor will then proceed to look for and locate the groove between the biceps and triceps muscles on the inner side of your upper arm.

He or she will then inject a local anesthetic and then use an applicator to insert the device just beneath your skin, above your large blood vessels and nerves.

Inserting the device too deep will make its removal difficult. After the procedure. You doctor will try to confirm the presence of Nexplanon by feeling your arm, he might also ask you to do the same.

If necessary an ultrasound or X-ray may also be used to confirm if the device has been inserted. Your doctor will then cover the insertion site with a small bandage.

Pressure might then be applied to the bandage to minimize bruising. The pressure bandage can be removed in 24 hours, but you must keep the small bandage clean and in place for up to three to five days.

It is quite common to experience to experience bruising to a certain extent, pain, scarring or bleeding at the insertion site.

Make contact with your doctor if you develop the following:

  • Breast lumps.
  • Heavy prolonged vaginal bleeding.
  • Signs or symptoms of a blood clot in your leg, such as persistent pain and swelling in your calf.
  • Signs and symptoms of jaundice, such as the yellowing of the skin and the whites of the eyes.
  • Signs or symptoms of an infection at the insertion site, such as tenderness, redness, swelling or discharge.
  • Signs or symptoms of pregnancy at any time after the insertion of the contraceptive implant.

Removal. Nexplanon can prevent pregnancy for up to three years. It must be removed and replaced at the three-year point to continue preventing a potential pregnancy.

Your doctor may recommend removing Nexplanon if you develop the following:

To remove the device from your body, you doctor will inject a local anesthetic in your arm beneath the implant.

He or she will then make a small incision in your skin and will push the implant toward the incision until the tip is visible and can grasp with forceps.

Your doctor will then pull out the implant, close the incision and then apply a pressure bandage to the incision site. The whole process of removing the implant typically takes less than five minutes.

If you choose, a new device will be implanted just after the other one is removed. You must be prepared to use another type of contraception right away if you do not have a new device inserted

6 Procedure Results

If you do not understand your contraceptive implant results, consult with your doctor.

Long-term contraception, of up to three years, is achievable after the contraceptive implant has been inserted.

7 Related Clinical Trials