Implanon

Posted in Contraception

Implanon
Download a PDF copy of the SHFPACT fact sheet Implanon here

Implanon is a 4cm long flexible plastic rod that contains a progesterone hormone. It works mainly by stopping the egg being released from the ovary (ovulation). It also increases the thickness of mucus in the cervix. If is over 99.9% effective as contraception. It last for three years, but can be removed earlier if you wish.

Insertion
Implanon is inserted just under the skin on the inside of the arm (usually the one that you don’t write with).  Insertion involves cleansing the skin, then a small injection of local anaesthetic to numb the area of skin. Next the Implanon is inserted, which doesn’t hurt.

Both you and your doctor will then feel the implant to make sure it has been inserted correctly. Then a firm bandage is put around the arm, which must be kept on for 24 hours, and the arm kept dry. This is to help reduce bruising and infection.

It makes sense to avoid heavy lifting with the arm for a few days. It is common to get some bruising and it may be a bit tender afterwards, and an itch can also occur. You are supposed to be able to feel the Implanon under your skin.

Insertion is done on day 1 to 5 of your cycle, with day 1 being the first day of bleeding. You should contact SHFPACT as early as possible to organize a suitable appointment once you get your period.

If you are changing from the pill or another method of contraception it may be done at another time of the cycle.

After having a baby Implanon can be inserted 21 or more days after the birth. Implanon can be used while breast feeding.

For your insertion appointment, remember to call SHFPACT as soon as your period starts to organize a suitable appointment time. Remember that you will need to keep your arm dry and leave the bandage on for 24 hours after insertion.

Removal
Implanon must be removed after three years, but can be removed earlier. When Implanaon is removed, the hormone leaves your body quickly and effects will wear off gradually. Fertility also returns quickly (in one study 94% of women ovulated within 1 month of removal).

For removal, the skin is cleansed and then a very small amount of local anaesthetic is injected under the lower end of the rod. A small cut is made in the skin – around 1cm. The Implanon is then pulled out. Steri-strips, a water resistant dressing and a bandage are placed over the cut. The bandage should be kept on for 24 hours, and the dressing left until the cut is healed. A small scare may occur. In some cases the Implanon may have become more deeply embedded and need to be removed under ultrasound guidance.

You will be given a card with the details of your Implanon and when it is due to be removed.

Who shouldn’t use Implanon?

Women who have:

  •  Breast cancer or reproductive organ cancers
  • Recent Deep Vein Thrombosis (clot in the leg)
  • Sever active liver disease
  • Being on medication which may interfere with the action of Implanon (eg. Tegretol, Dilantin, some oral anti-fungal drugs)
  • The possibility of  pregnancy
  • Undiagnosed abnormal vaginal bleeding
  • Major bruising problems
  • Allergic reactions to local anaesthetic

Advantages

  • Contraceptive cover straight away if inserted in the first five days of your cycle.
  • Lasts up to 3 years with effective contraception
  • Can be removed if side effects are not improving or pregnancy is desired
  • Nothing to remember on a daily basis
  • Fertility returns quickly after Implanon is removed
  • No problems with bone density or osteoporosis
  • Low cost

Possible Side Effects

  • The insertion of Implanon involves a minor surgical procedure which is required for the implant to be inserted under the skin; a local anaesthetic is used. Possible problems after the insertion include – bruising, soreness, infection and minor scarring. The implant may be difficult to remove if the scarring is great or if the Implanon becomes deeply embedded over time. In the unlikely event that the Implanon cannot be removed by the inserting doctor or under ultrasound at a diagnostic imaging center, referral to a surgeon at the client’s own expense may be necessary.
  • Changes in bleeding patterns occur in most women. It is not possible to know before Implanon is inserted what changes each woman will have. Around 20% of women have no bleeding. Around 30% of women get fairly regular bleeding. Over 25% of women have infrequent bleeding (which is unpredictable). Under 20% of women have frequent or prolonged bleeding. It is possible for bleeding patterns to change over time with Implanon. The majority of women get less bleeding, less often. Frequent bleeding is more common early on. It is important to consider how you would manage with some uncertainty in your bleeding pattern before you have Implanon inserted.
  • Progesterone related side effects include acne, weight gain, breast tenderness, headaches and changes in mood. These tend to settle down after the first thre months.

Other Considerations
As with all forms of contraception regular reviews for pap smears are required and a follow up visit should be made 3 months after insertion for review.

A woman interested in using Implanon should be prepared to attend two appointments. The first to discuss how well Implanon will suit you (half an hour) and to get a prescription. The second for insertion of Implanon (15 minutes).

Download a PDF copy of the SHFPACT fact sheet Implanon here

 

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