What is the implant?
There are two basic forms of the implant, which both work in the same way. The implant is a thin, flexible piece of plastic about the size of a matchstick that rests under the skin of the upper arm. It releases a small dose of the hormone progesterone, which works in the same way as the birth control pill, suppressing ovulation, increasing cervical mucus to prevent sperm from entering the uterus, and thinning the uterine lining to discourage implantation if fertilization occurs. The implant is effective for up to three years, after which it must be replaced for continued birth control.
The most commonly used implant in the United States is Implanon, which the FDA approved for use in 2004. In 2011, the FDA approved a newer version of Implanon, called Nexplanon, which is virtually identical to the original model but with two added benefits. Firstly, Nexplanon is radio opaque, meaning that is visible on x-rays. This is useful for checking where the implant is located after insertion. Nexplanon also has a slightly different applicator which reduces the risk of insertion errors seen with Implanon, especially when inserted by doctors without the proper training. Both implant options are currently available in the US. Neither type of implant prevents against STDs.
How effective is the implant?
The implant is nearly 100% effective, meaning that less than 1 in 100 women with an implant will become pregnant every year. This statistic tends to hold true for every woman because no upkeep is necessary.
However, research has shown that the implant tends to be less effective for women who are overweight or on certain antibiotic medications, so it is important to consult your doctor if you are considering taking any medications on the implant.
What are myths associated with the implant?
1. The implant can move around the body.
The implant cannot travel within the body. After insertion, a small amount of connective tissue forms around the plastic, keeping it in place until removal. There have been rare instances of a process called expulsion, in which the implant begins to push its way out of the skin. This is generally the result of faulty implantation, and tends not to occur after the first four months after insertion. If expulsion occurs, a woman should return to the office where her implant was first inserted and have it removed or replaced, using backup forms of birth control like condoms during the interim.
2. Implant insertion is a large, painful surgical procedure.
This myth generally arises from a misunderstanding of the method used for insertion. During implantation, your doctor will inject a local anesthetic into the insertion site. They will then use an applicator to place the implant in a shallow groove under the skin of your inner arm, between your biceps and triceps muscles. Properly inserted implants will be above the blood vessels and the nerves, as deeper insertion makes removal more difficult. The applicator used with Nexplanon decreases the risk of deep insertion by making the application procedure slightly simpler.
3. The implant will cause problems with the arm.
Many women believe that they will be able to feel the implant in their arm, and that it will effect the way that they are able to use that arm and its muscles. After insertion, you will be able to feel a bump where the implant is, in fact the doctor will have you feel the area to confirm implantation and know where to feel for the possibility of expulsion. However, this bump will not affect your mobility. Women typically experience swelling and bruising for a few days after implantation, but these tend not to last longer than five days. Some doctors will provide you with a small pressure bandage to reduce these effects, which can be removed within 24 hours. Women will also have another small bandage that should be kept clean and dry, and cover the insertion site for about five days.
4. The implant can cause infertility.
Like the birth control pill, the implant is a hormonal contraceptive method and is only effective while the hormones are present in the body. As soon as the implant is removed, its effectiveness is lost and ovulation resumes as before. Women are able to conceive within as little as a week following implant removal, so women who do not want to get pregnant are highly encouraged to either replace their implant or immediately begin using an alternative form of birth control.
5. The implant decreases sex drive.
Certain women have reported lower sex drives after implant insertion, but the implant is not believed to be the direct cause, as other women report increased libidos. As it stands, the exact cause of this change is not really understood, but is believed to be psychological. Perhaps some women are less worried about getting pregnant, allowing them to be more open in their sexual decisions, while others may be worried about their new form of birth control, stifling their sexual desires. If the change in sex drive is negative, women should consider talking to their doctors about switching methods.
What are the disadvantages of the implant?
The implant is an excellent and effective contraceptive, but, like every form of birth control, it does have certain drawbacks as well. The most common side effects are breast swelling and tenderness; cramping, especially during menstrual periods; bloating; and weight gain. These are generally minimal and are found with most methods of hormonal birth control.
Some women are also discouraged by the price of the implant, which runs between about $400 and $800 for the rod and its insertion. Over three years, this evens out to between around $11 and $22 per month, which is about the same as the birth control pill. Additionally, most medical insurers cover the implant, and certain healthcare providers and clinics subsidize insertion and allow for payment plans to cover this form of birth control, reducing the upfront cost. If payment is an issue for you, talk to your insurance company or healthcare provider to discuss your coverage and options.
Where can I get the implant?
The implant must be ordered and inserted by a doctor. Insertion requires special training, which not every doctor has undergone yet. Talk to your doctor if you feel that the implant might be right for you, to see if their office is equipped for insertion, or if they have a referral for another doctor who can perform the procedure.