Contraceptive implants are a long-term birth control option for women. 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 cervical mucus and thin the lining of the uterus (endometrium). Contraceptive implants typically suppress ovulation as well.
One version of contraceptive implant — Implanon — was discontinued by its manufacturer in 2014 and replaced with a newer version called Nexplanon. Nexplanon is radio opaque, which means it can be seen on X-ray, which is useful for checking the location of the implant.
Contraceptive implants offer effective, long-term contraception. Among various benefits, a contraceptive implant:
Contraceptive implants aren't appropriate for everyone, however. Your health care provider may discourage use of a contraceptive implant if you:
Although the label for etonogestrel (Nexplanon) says it shouldn't be used by women with a history of blood clots, it isn't clear whether the contraceptive implant 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 the contraceptive implant.
Talk to your health care provider if you have any risk factors for blood clots, including a history of blood clots in your legs or a prior diagnosis of a blood clot in your lungs (pulmonary embolus).
In addition, tell your health care provider if you have a history of:
The contraceptive implant isn't contraindicated for use in women who are overweight. 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.
The contraceptive implant doesn't offer protection from sexually transmitted infections.
Fewer than 1 out of 100 women who use the contraceptive implant for one year will get pregnant. If you do conceive while using a contraceptive implant, there's a higher chance that the pregnancy will be ectopic — when the fertilized egg implants outside the uterus, usually in a fallopian tube. However, because a contraceptive implant prevents most pregnancies, women who use it are at lower risk of having an ectopic pregnancy than are other sexually active women who aren't using contraception.
Side effects associated with contraceptive implants include:
Your health care provider will evaluate your overall health before inserting the contraceptive implant. He or she will determine the appropriate timing for the insertion of the implant based on your menstrual cycle and your previous birth control method. You may need to take a pregnancy test and use a nonhormonal backup method of contraception for one week.
A backup method of contraception may not be necessary if you previously:
You can have a contraceptive implant inserted during a visit to your health care provider's office. The actual procedure takes just a minute or so, though preparation will take a bit longer.
You'll lie on your back with the arm that will receive the implant bent at the elbow and positioned near your head. Your health care provider will locate a groove between the biceps and triceps muscles on the inner side of your upper arm. He or she will inject a local anesthetic and then use an applicator to insert the device just beneath your skin. Inserting the device too deeply makes removal difficult.
Your health care provider will feel your arm to confirm the presence of the implant and have you do the same. If necessary, he or she may also use an ultrasound or X-ray to confirm that the device has been inserted.
Your health care provider will cover the insertion site with a small bandage. He or she may also apply a pressure bandage to minimize bruising. You can remove the pressure bandage in 24 hours, but keep the small bandage clean and in place for three to five days.
It's common to experience some degree of bruising, pain, scarring or bleeding at the insertion site.
Contact your health care provider if you develop:
The contraceptive implant can prevent pregnancy for up to three years. It must be removed and replaced at the three-year point to continue offering protection from unintended pregnancy.
Your health care provider may recommend removing the contraceptive implant earlier if you develop:
To remove the device, your health care provider will inject a local anesthetic in your arm beneath the implant. He or she will make a small incision in your skin and will push the implant toward the incision until the tip is visible and can be grasped with forceps.
Your health care provider will then pull out the implant, close the incision and apply a pressure bandage. Contraceptive implant removal typically takes less than five minutes.
If you choose, a new device can be implanted as soon as the original device is removed. Be prepared to use another type of contraception right away if you don't have a new device inserted.
A contraceptive implant can prevent pregnancy for up to three years. It must be removed and replaced every three years to continue prevent pregnancy.