Contraceptive

Implants
WHAT THE HECK ARE THEY?!

What is a contraceptive implant?

Nexplanon (a brand of the implant) is a small, thin, flexible tube
about 4cm long. It is implanted under the skin of your upper
arm by a doctor or nurse.. The small wound made in your arm is
closed with a dressing and does not need stitches.
Nexplanon works for up to three years before it needs to be
replaced. You can continue to use it until you reach the
menopause, when a womans monthly periods stop (at around
52 years of age). The implant can be removed at any time by a
specially trained doctor or nurse. It only takes a few minutes to
remove, using a local anaesthetic.
As soon as the implant has been removed, you will no longer be
protected against pregnancy.

How it works
The implant steadily releases the hormone progestogen
into your bloodstream. Progestogen is similar to the
natural hormone progesterone, which is released by a
woman's ovaries during her period.
The implant can beput inat any time during your
menstrual cycle, as long as you and your doctor are
reasonably sure you are not pregnant. In the UK,
Nexplanon is the main contraceptive implant currently in
use. Implants insertedbefore October 2010 were called
Implanon. Since October 2010, insertion of Implanon has
decreased as stocks are used up, and Nexplanon has

The effects of progestogen

The continuous release of progestogen:
stops a woman releasing an egg every month (ovulation)
thickens the mucus from the cervix (entrance tothe
womb), making it difficult for sperm to pass through to the
womb and reach an unfertilised egg
makes the lining of the womb thinner so that it is unable
to support a fertilised eggplant

Picture of Contraceptive Implant

Apparatus

Illustration of how implant is

applied

Actual implant about to be inserted

into forearm of the patient

As taken from Association of Reproductive Health Professionals

(https://www.arhp.org/publications-and-resources/clinicalproceedings/Single-Rod/Rationale)
Statistics Show that:

Effectiveness
According to
If implanted correctly, it's more than 99% effective.
Less than one woman in 1,000 who use the implant as
contraception will get pregnant in one year.
Some medications can make the implant less effective,
and additional contraceptive precautions need to be
followed when you are taking these medications;

Effectiveness

These include:
o medication for HIV
o medication for epilepsy
o complementary remedies, such as St John's Wort
o an antibiotic called rifabutin (which can be used to treat
tuberculosis)
o an antibiotic called rifampicin (which can be used to treat
several conditions, including tuberculosis and meningitis)

Effectiveness
These are called enzyme-inducing drugs. If you are using these medicines for
a short while (for example, rifampicin to protect against meningitis), it is
recommended that you use additional contraception during the course of
treatment and for 28 days afterwards. The additional contraception could be
condoms, or a single dose of the contraceptive injection. The implant can
remain in place if you have the injection.
Women taking enzyme-inducing drugs in the long term may wish to consider
using a method of contraception that isn't affected by their medication.
Always tell your doctor that you are using an implant if you are prescribed
any medicines. Ask your doctor or nurse for more details about the implant
and other medication.

Advantages
According to the National Health Services (http://www.nhs.uk), the main

Advantages of the Contraceptive Implant include:

If implanted correctly, it is more than 99% effective. Less than one woman in
1,000 who use the implant as contraception will get pregnant in one year.
One does not have to remember to take a pill every day.
The implant is safe to use while breastfeeding.
The implant offers some protection against pelvic inflammatory disease as
the mucus from the cervix may stop bacteria from entering the womb and
may also give some protection against cancer of the womb.
The implant may reduceheavy periodsorpainful periodsafter the first year
of use.

Advantages
It is an option for people who cannot use oestrogen-based contraception,

such as: the combined contraceptive pill, contraceptive patch or vaginal

ring.
The implant does not interfere with having sex (intercourse).
The implant protects against pregnancy for 3 years.
Ones fertility will return to normal immediately after the implant has
been removed.
The implant can be fitted immediately after a miscarriage or an abortion,
and you will immediately be protected against pregnancy.
One can have the contraceptive implant fitted after given birth, usually
after three weeks.

Disadvantages
According to National Health Services N.H.S. (http://www.nhs.uk/) some

of the disadvantages that should be carefully considered are:

Disrupted Periods - Your periods may change significantly while using a
contraceptive implant. Around 20% of women using the implant will have
no bleeding, and almost 50% will have infrequent or prolonged bleeding.
Headaches Some women may have frequent headaches because of the
sudden change in their bodys environment and menstrual cycles. If you
have prolonged or severe headaches or other side effects, tell your
doctor.
Acne - Breakouts may be seen in women who are even above the age of
30.
Changes in mood
Loss of sex drive

Disadvantages
Nausea
Breast tenderness
According to Healthline (http://www.healthline.com/) The

contraceptive implant does have several disadvantages,

including:
No protection against sexually transmitted infections.
High up-front cost if not covered by insurance.
Insertion requires a doctors visit.
Device must be removed after three years.

Things to Consider

It may not be suitable if you:

have severe liver disease
have unusual vaginal bleeding
take medication that makes the implant less effective
have blood clots in your legs or lungs
can't take the hormone progesterone

Bibliography
British National Health Service (NHS). (2014, December 31). Contraceptive
Implant - Contraception Guide. Retrieved from National Health Service :
http://www.nhs.uk/conditions/contraception-guide/pages/contraceptiveimplant.aspx
Family Planning Association (FPA). (2014, June). Your Guide to the
Contraceptive Implant. Retrieved from Family Planning Association:
http://www.fpa.org.uk/sites/default/files/contraceptive-implant-your-guide.pdf
Health Line - Healthline Editorial Team Published on18 August 2014
Medically Reviewed byPatricia Geraghty MSN, WHNP, FNP-BCon 18 August
2014 - Birth Control Implant: http://www.healthline.com/health/birth-controlimplant#Overview1