Implant insertion

The contraceptive implant is the most effective form of contraception on the market. At best, if 1000 women used a coil for contraception, less than 1 woman would get pregnant.
This is even more effective than getting your tubes tied! When you get the implant inserted you don’t have to think about your contraception for 3 years!

This can be a difficult decision, and it’s important to consider your immediate and long-term contraceptive needs, bleeding patterns, medical history, and past contraceptive experiences. You may have done your own research and have already made a decision about an implant. It is an extremely reliable method of contraception and a particularly good choice if you can’t have contraception containing oestrogen.

The implant stops the release of an egg from the ovary. This means that it blocks the ovulation process. The progesterone hormone in the implant also thickens the cervical mucus, making it harder for sperm to move through your cervix. It also makes the lining of the uterus thin and inactive.

An Implant can be inserted at any time in your cycle, if it is reasonably certain that you are not pregnant. The ideal time is between Day 1 and 5 of a natural period. This is because we can be sure you are not pregnant at this time. After Day 5, you can still have an implant fitted if you have not had any unprotected vaginal intercourse since the start of your period. If you have had unprotected vaginal intercourse after day 5, you may be at risk of pregnancy so you will need to speak to a doctor prior to your fitting.

If you have been using a hormonal method (such as the Combined Contraceptive Pill, Ring, Patches; Progesterone-Only-Pill; or injection method), consistently and correctly (with no missed pills /ring/patch and your injection or implant is not overdue), the implant can be fitted at any convenient time, and you do not need to abstain from sex before your fitting. You will have to carry on with the previous method for another 7 days after the implant fitting.

Having an implant fitted is not usually a painful procedure.  We numb the skin by injecting lidocaine local anaesthetic under the skin.   Injection of the local anaesthetic can sting a bit but only for a few seconds.

An implant should only be inserted by a Healthcare Professional trained in this procedure. A urine pregnancy test is always done prior to a fitting. The point of insertion is identified and marked. A local anaesthetic (called lidocaine) is used to numb the skin. The implant is then inserted with the aid of a fitter within a few seconds. The small wound at the point of insertion is closed with a sterile dressing and does not need stitches. A pressure bandage is placed around the dressing to reduce the risk of bruising. The bandage can be removed after 24 hours. The sterile dressing is usually removed after 3 to 5 days.

Remember, You will need to wait 7 days to use it as your sole form of contraception, so you will need to abstain from penetrative sex or use condoms during the waiting time. If you are taking the contraceptive pill (either the combined pill or progesterone-only pill) carry on for another 7 days.

Your periods may change significantly while using a contraceptive implant. Around 20% of women using the implant will have no bleeding (amenorrhoea), and almost 50% will have infrequent or prolonged bleeding. Furthermore, the bleeding pattern can change at any time during the use of the implant. Studies indicate that those with challenging bleeding patterns in the first few months after insertion of an implant may have about a 50% chance that bleeding will improve over time.

Although changes in bleeding patterns are not harmful, they can be unacceptable and are a common cause of discontinuation of the method. Before making the decision to get it removed, you should talk to us or your regular doctor as there are ways in which problematic bleeding can be managed.

As previously mentioned, the implant delivers progesterone hormone slowly into the bloodstream. Therefore, you can experience side effects of acne, headache, breast tenderness, mood changes and bloating. This is called progesterone intolerance. These symptoms can occur at any stage during the lifetime of the implant.

Certain medications and herbal products may decrease the levels of progesterone released by the implant and as a result reduce its effectiveness. Medications known to interact with the effectiveness of the contraceptive implant include some seizure medications, certain sedatives, some antibiotics used to treat tuberculosis or meningitis, some HIV medications, as well as the over-the-counter herb, St. John’s wort. We advise speaking to us or your regular doctor if you take any of the medicines so that we can discuss the best method(s) of contraception for you.

The implant can be fitted at any time after childbirth including immediately after delivery. As a general rule of thumb, contraception is required from day 21 after childbirth and if the implant is fitted by day 21 after delivery it will be effective immediately with no additional contraception required. If it is fitted on or after day 21, you will need to use an additional contraception, such as condoms, for the following 7 days after the fitting.

It is safe to use the implant when you are breastfeeding.

The implant can be safely fitted at any time after a termination of pregnancy (TOP) or miscarriage. If fitted within 5 days after a TOP or miscarriage, it will be effective immediately with no additional contraception required. If it is fitted after Day 5, you will need to use an additional contraception, such as condoms, for the following 7 days after the fitting.