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What to expect after getting a contraceptive implant
The contraceptive implant is a type of contraception. It is subdermal (under the skin) and is put inside your arm. The implant works by releasing a hormone called progesterone. This prevents you getting pregnant and can last up to three years. Here, I talk about what to expect after getting an implant. This includes how effective it is, side effects and implant removal.
What does the contraceptive implant do?
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. It is a flexible plastic rod about the size of a matchstick, which is placed in your arm. It can last up to three years. The implant slowly releases progesterone to stop you ovulating so that you don’t get pregnant.
How effective is the contraceptive implant?
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 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, you should 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 people 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), so you will need to use a condom.
Are there any contraceptive implant side effects?
You may experience a little discomfort at the insertion site once the local anaesthetic wears off. You might want to take pain relief such as paracetamol. Any bruising should settle within a week. You can do your normal activities but avoid any heavy lifting on the day you get the implant. 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 goes down within a couple of months. You can relieve itching by taking antihistamines like cetirizine or chlorphenamine (Piriton). These are available over the counter at a pharmacy. You should try to avoid scratching or picking around the healing area of the implant.
Most other side-effects are rare. They can include headaches, nausea, breast pain and weight change.
What does the contraceptive implant do to periods?
The implant can cause your periods to become less regular. Some people have no periods and others will have irregular spotting or light periods. A few people 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.
Can anything go wrong with the contraceptive 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
When do I need to replace 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. If you are trying to get pregnant you should ideally take the following supplements.
- 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 which is a neural tube defect (NTD) affecting the spine.
- Vitamin D supplement of 10mcg of 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.
Once you remove the implant, you can get pregnant soon after. You need another contraceptive method to prevent this. If you have concerns, talk to your doctor for advice.
During implant removal 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.
We offer a range of sexual health services within our Bupa Health Centres. So whether you have symptoms and need to speak to a GP or don't have symptoms but want a check to see if you currently have an STI we have a check to suit you. Any customers who test positive receive a follow up with a GP and support from our 24/7 Nurse HealthLine. Learn more today.
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Sources Sources
- 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 2023
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