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The contraceptive implant: continuous contraception for 3 years

The contraceptive implant is a little-known method of contraception. However, it is more than 99% reliable and is a good compromise when you cannot tolerate IUDs or when you forget your pill too often. Read all about this contraceptive system.

What is a contraceptive implant?

The contraceptive implant is a contraceptive system that allows the continuous delivery of progesterone (etonogestrel): it blocks ovulation and modifies the cervical mucus in order to oppose the progression of spermatozoa.

In France, the contraceptive implant is known as Nexplanon®.

It is indicated for women who do not want to take the pill every day or who often forget their pill, as well as for women with contraindications to estro-progestogens or the IUD.

It comes in the form of a small, flexible plastic stick 4 cm long and 2 mm wide. This stick is inserted under the skin of the forearm.

How is it applied? Does it hurt?

Before the contraceptive implant is placed, the doctor performs a local anesthesia. Then, he makes a small incision and places the implant under the skin, inside the forearm, using a hollow needle.

The placement takes only a few minutes and is completely painless.

The scar does not measure more than 2 millimeters.

Is the contraceptive implant effective?

The concentration of progesterone is sufficient to ensure contraception as early as 24 hours after its installation.

It allows effective contraception, over 99%.

Is the contraceptive implant well tolerated? Are there any side effects?

Once in place, the contraceptive implant is well tolerated and absolutely painless.

Some side effects may occur after implant placement, including changes in vaginal bleeding: the appearance of irregular bleeding (absent, less frequent, more frequent or continuous) and changes in the intensity of bleeding (reduced or increased) or its duration.

Frequent or prolonged bleeding was reported in 1 woman/5. Similarly, amenorrhea was reported in 1 woman/5 as well.

Breast tension, acne, headaches, and weight gain may also occur after implant placement.

At what point in the cycle should the implant be placed?

Before an implant is placed, it is important to check that there is no pregnancy in progress.

Afterwards, it depends on the case:

  • If the woman was not using hormonal contraception during the previous month, the implant must be inserted between the 1st day (first day of menstruation) and the 5th day of the menstrual cycle, even if the woman is still bleeding.
  • If the woman wants to place an implant as a replacement for a combined hormonal contraceptive (estrogen-progestin oral contraceptive, vaginal ring or transdermal patch), the implant should preferably be inserted the day after she has taken the last active tablet (the last tablet containing the active substances) of her previous combined oral contraceptive or on the day the vaginal ring or transdermal patch is removed.
  • If the woman was using progestin-only contraception, she can switch from the purely progestin-only pill to the contraceptive implant on any day of the month (the implant must be inserted within 24 hours of taking the last tablet).
  • If the woman had an IUD (intrauterine system), the implant must be inserted on the day the IUD is removed.
  • After pregnancy and if the woman is not breastfeeding, the implant should be inserted between the 21st and 28th day after delivery. If the woman is breastfeeding, the implant should be inserted after the 4th week after delivery.

How long does an implant work?

The duration of use of the contraceptive implant is approximately 3 years.

The removal is done under local anesthesia and is not painful. A new implant can be inserted in the same arm and through the incision made to remove the previous implant.

However, it should be noted that there have been a few cases of migration of the implant: it may have made a minor displacement from its original position. Removal may require a larger incision and more time.

Are there any contraindications for implant placement?

Of course, pregnancy is a formal contraindication.

Furthermore, implants are not placed in people who have had a progressive venous thromboembolic accident, suffer from severe liver disease or a malignant tumor.

Likewise, the implant is avoided in women who have undiagnosed genital bleeding.

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