After getting the contraceptive implant
Your health expert: Dr Sam Wild, Bupa GP and Women’s Health Lead
Content editor review by Rasheda Begum, September 2023
Next review due September 2025
Subdermal (under the skin) implants are a type of hormonal contraception containing the hormone progesterone. In the UK, this is available as the licensed Nexplanon® implant, a flexible plastic rod about the size of a matchstick, which is placed in your arm. It can last up to three years.
After insertion of the implant
You may experience a little discomfort at the insertion site once the local anaesthetic wears off. You might wish to take pain relief such as paracetamol. Any bruising should settle within a week of insertion. You can carry out all your normal activities but avoid any heavy lifting on the day you had your implant fitted. You will need to keep any dressings clean, dry and in place for five days before removing them by soaking in the shower or bath, unless told otherwise.
If there is pus, bleeding or strong pain at the insertion site, seek medical advice as you may have an infection and need antibiotics.
You might have itching at the site of insertion. This usually settles within a couple of months. You can try taking antihistamines, such as cetirizine or chlorphenamine (Piriton), available over the counter at a pharmacy, to relieve itching. You should try to avoid scratching or picking around the healing area of the implant.
When the implant starts working
This can depend on when you had the implant fitted. If you had the implant fitted on the first five days of your menstrual cycle, then you will be protected immediately from pregnancy and won’t need to use any other contraception. If you had it fitted at any other time of your menstrual cycle, you need to ensure you use another form of contraception, or abstain from sex for seven days after insertion, unless your doctor has informed you otherwise.
The implant is a very effective contraceptive. Less than 1 in 1,000 women will get pregnant while they have the implant. If you do get pregnant, there is no evidence the implant will affect the development of the pregnancy. You should seek medical advice if you get pregnant. The implant doesn’t protect you from sexually transmitted infections (STIs), you will need to use a condom.
Bleeding pattern
The implant can cause your periods to become less regular. Some women have no periods and others will have irregular spotting or light periods. A few women have bleeding that goes on for longer. It can take up to three months for your bleeding pattern to settle after insertion. If you have concerns about your bleeding pattern, you should contact a GP. Medications can help to improve the bleeding pattern. Most other side-effects are rare and can include headaches, nausea, breast pain and weight change.
Problems with the implant
You should seek medical advice if:
- you can’t feel the implant (you should use another method of contraception if this happens)
- the implant becomes an unusual shape
- there are changes in the skin around the implant
- you have any pain around the implant
- you become pregnant
Removing and replacing the implant
You will need to have the implant changed after three years. You can have the implant removed any time for example if you wish to have children. Ideally you should consider taking a folic acid supplement of 400mcg a day for three months prior to having the implant removed. This can help reduce the chance of a foetus developing spina bifida. It’s recommended that all women take 10mcg of vitamin D daily when you’re trying to get pregnant, and throughout pregnancy. It can be a good idea to start this before you’re pregnant to make sure you have enough vitamin D. You can buy pregnancy supplements that contain the right amount of both folic acid and vitamin D from most pharmacies and supermarkets.
Once you have the implant removed, you could get pregnant very quickly, unless you have another contraceptive method in place. If you are concerned about this, speak to your doctor for advice or to discuss an alternative method of contraception.
To remove the implant, you will be given a local anaesthetic followed by a small cut to remove the implant. In rare cases (one in 100) it may not be possible to have the implant removal under local anaesthetic and it may need to be done at a specialist clinic under ultrasound. If you’re having your implant replaced, the new one can be put in the same place.
Contraception
Sexually transmitted infections (STIs)
Planning for pregnancy
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- Progestogen-only Subdermal Implants. Patient. patient.info/doctor, last edited May 2019
- Contraception – progestogen-only methods. Management Scenario: Progestogen-only implant. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised March 2021
- Personal communication, Dr Sam Wild, Bupa GP and Women’s Health Lead, September 2022
- Addendum to Clinical Guideline 30, Long-acting reversible contraception. NICE clinical guideline CG30.1 NICE
- Pre-pregnancy counselling. Patient. patient.info/doctor, last edited November 2020
- Pregnancy. Pre-conception and early pregnancy counselling. Oxford handbook of general practice. Oxford Medicine Online, published online June 2020
- Spina bifida and neural tube defects. Management-Prevention. BMJ Best Practice. bestpractice.bmj.com, last updated August 2022
