Implanon Insertion & Removal

Implanon is the brand name for the contraceptive implant containing the hormone progestogen.

What is Implanon?

Implanon is a small flexible rod, which is inserted under the skin of the upper arm. It slowly releases progestogen (a hormone like the hormone progesterone, which is naturally produced by the female body) into the blood stream to prevent pregnancy for up to three years.

How does Implanon work?

The implant works by:

• preventing ovulation (egg release from the ovary)
• thickening of the mucus of the cervix so that sperm cannot enter the uterus (womb)
• changing the lining of the uterus, making it unsuitable for pregnancy

How effective is Implanon?

Implanon is at least 99.9% effective. This means that if 1,000 women use Implanon for a year it is possible that 1 woman could become pregnant.

Some medications can reduce the effectiveness of Implanon. It is important to inform doctors you have an Implanon when other medication is prescribed.

What are the advantages of Implanon as a method of contraception?

• highly effective
• long acting (lasts 3 years)
• does not require daily pill taking or regular injections
• reversible and rapid return to usual fertility (most women ovulate within the first month after removal of the implant)
• inexpensive

What are the disadvantages of Implanon as a method of contraception?

Implanon changes bleeding/period patterns. These changes are a result of the hormonal effect to the lining of the uterus.

It is not possible to predict which changes will occur, but they can include:

• very occasional bleeding or no bleeding at all (this occurs in about 1 in 5 women)
• irregular light bleeding
• prolonged and/or frequent bleeding which is usually light, but can cause inconvenience (this occurs in about 1 in 5 women)
• heavier prolonged bleeding very rarely occurs

The type of bleeding pattern experienced in the first 4 months of use may predict the ongoing pattern.

For women experiencing continued bleeding problems, a change of contraceptive method may need to be considered.

Other disadvantages:

• requires a minor medical procedure for both insertion and removal
• the possibility of skin bruising after insertion and scarring after removal
• does not protect against sexually transmitted infections (STIs)

What are the possible health benefits of Implanon?

• Some women will have no bleeding or minimal bleeding only
• May reduce painful periods, premenstrual symptoms (PMS) and acne in some women

What are the possible side effects of Implanon®?

Side effects could include:

• Headaches
• Mood changes
• Breast tenderness
• Acne
• Decreased sexual interest
• Changes in weight Research shows that women may lose weight, stay the same or gain weight while using Implanon.

What are the possible risks associated with Implanon®?

The risks associated with insertion and removal include:

• Bruising and soreness at the site for up to 1 to 2 weeks
• A small scar – a small number of women are predisposed to the development of thickened scars
• Allergic reactions to the local anaesthetic or the implant materials
• Infection at the insertion/removal site
• Difficult removal of the implant – requiring specialist procedure with possible increase in scarring and costs

Is Implanon suitable for all women?

Most women can safely use Implanon.

Our doctor will review the suitability of the method with you prior to insertion.

In assessing your suitability, consideration is given to a number of important factors:

• if you have liver disease
• if you have or have had breast cancer
• unexplained vaginal bleeding (this should be investigated before using an Implanon)

The doctor will also review any medications that may interfere with the implant working effectively.

If your general health changes, the suitability of this method should be reassessed.

What do I need to know about having an Implanon inserted?

Insertion and removal involves a small surgical procedure with local anaesthetic. This should be done by a doctor trained in this procedure.

Prior to insertion, an assessment of your medical history and suitability for this method will happen.

This assessment enables you to ask any questions you may have and be certain that it is the most suitable method for you.

It also ensures that insertion happens at the right time of your menstrual cycle.

Implanon is usually inserted during the first 5 days of the menstrual period to ensure the woman is not pregnant.

It is very important that there is no chance of an early pregnancy at the time of insertion as the changes in bleeding patterns caused by Implanon may delay diagnosis of pregnancy.

Sometimes condoms or abstaining from sex will then need to be used for a further 7 days after insertion, before the implant can be relied on to prevent pregnancy.

What do I need to know about the ongoing use of Implanon?

The Implanon implant needs to be replaced ever 3 years.

After 3 years, the effectiveness reduces and if a pregnancy occurs there is a small increase in the risk of this pregnancy implanting in the Fallopian tube (ectopic pregnancy). This is a serious condition and can lead to reduced fertility.

It is very important to keep a record of the date that replacement is due and to arrange for replacement no later than this date. A single procedure can be used to remove an old implant and put in a new one.

Implanon can easily be removed at any time. As fertility can return immediately after removal, it is important to consider alternative methods of contraception before the implant is removed, if trying to avoid pregnancy.

To make sure you are protected against both pregnancy and STIs, use Implanon, plus a condom, for best protection.