Are contraceptive implants for females safe?

What’s covered?

This is a must read before using a contraceptive implant

What is a birth control implant?

Are you fed up with contraceptive pills and want a long-term solution? Then, be happy; a contraceptive implant could work for you. These progesterone-containing devices are placed under the skin by a doctor or nurse and are effective for years. Such implants are increasing in demand as a report published by BBC in 2011 has claimed that more than 1.4 million women have used these implants in the first 12 years of introduction.

How do these implants work? What is their contraceptive efficiency? How safe are they? Potential users often ask these questions. So keep reading for the answers.

How the contraceptive implants prevent pregnancy?

How does a contraceptive implant work? These implants use hormonal birth control mechanisms. They contain the synthetic analogues of progesterone, e.g., the two famous brands available in the UK, Implanon® and Nexplanon®, have etonogestrel. Nexplanon was introduced as a replacement for Implanon. Both contain 68mg of etonogestrel.

These birth control implants are placed under the skin through surgery. An implant steadily releases progesterone into your bloodstream. This progesterone manipulates your menstrual cycle by suppressing the LH (luteinizing hormone) surge, which is necessary for ovulation (releasing an egg from the follicle in the ovary).

Besides the suppression of ovulation, a contraceptive implant also uses other mechanisms of contraception, e.g.,

• Thinning of the wall of the uterus so that it can't support the attachment of the foetus.
• Thickening of the cervical mucus, thus making it difficult for the sperms to move through it.

Why should you choose a contraceptive implant?

An implant is a complete contraceptive package for you, just like progesterone-only pills. However, why would you undergo the pain of its surgical implantation? Is there any extra benefit? It has one significant advantage over pills. Once It is placed, you are free from worries of unplanned pregnancies for years to come.

How is a contraceptive implant inserted?

A birth control implant is in the form of small plastic rods not more than the size of a few centimetres (Nexplanon is just 4cm long with a diameter of only 2mm-Figure 1). Therefore, its application doesn't require extensive surgery.

You will need to go to your gynaecologist. It is a routine procedure at contraception clinics. They will use a local anaesthetic to desensitise a small area on your upper arm. Then, they will place it under the skin just like a needle. No stitches are necessary after this procedure.

The doctor may recommend analgesic (painkilling) medicines to reduce the pain, but it is often unnecessary. You can now enjoy safe sex without worrying about missing pills and unplanned pregnancies.

A single implant is enough for up to 3 years. Occasionally, it will continue to work for up to 4 years. Then, a trained nurse or doctor could easily remove it using the same procedure.

What's the efficacy of these implants?

The idea might have attracted you. Are you feeling curious about its efficacy? Its effectiveness is comparable to other contraceptive methods. For example, slow progesterone-releasing implants have more than 99% efficacy in preventing pregnancy.

Its failure rate of just 0.1% makes it a better choice than progestin injection (4%), combined pills (7%), progestogen-only pills (7%), contraceptive ring (7%), the male condom (13%) and female condom (21%). Research published in the European Journal of Contraception and Reproductive Health Care has confirmed this figure.

Remember that no contraceptive method protects against sexually transmitted infections (STIs). So, you have to use other mechanisms for safe sex, e.g., a male condom.

Are they safe?

To understand the safety of these implants, you need to understand their potential disadvantages and health risk. The health issues you may experience by installing these implants in your upper arm are;

Local area infections

The implantation site may get infected. You may need to take antibiotics and analgesics for many days.

Chances of pregnancy

It works in more than 99% of the cases. However, what if you are among the remaining 0.1%? A 99.9% efficiency means that the chance of a user still getting pregnant with these implants is very minimal. You can combine an implant with a male condom for better results.

Problems with the implants

The implants are often lost. How? You may not remember the site of its implantation. So, the removal may become difficult. Additionally, you may feel pain at the implantation site despite using a local anaesthetic injection.

Cost

Cost is not related to your health. However, it may be a hindrance to your access. For example, clinics in the UK charge more than £300 for placement and similar high charges for replacement or removal.

Side effects

Like other medical interventions, these hormonal implants have various side effects. Keep in mind these effects before choosing the implant for contraception.

These side effects are:

• Inflammation at the injection site may occur, resulting in pain, redness, swelling and scar formation at the implantation site.
• Irregularities of menstrual bleeding
• Mood swings and depression due to disturbances of hormones
• Dizziness
• Abnormal weight gain can expose you to various other problems.
• Breast tenderness and pain
• Bruising and irritation at the site of implantation.
• Back pain and severe headache
• Noncancerous ovarian cysts
• Digestive problems, e.g., nausea and pain
• Skin problems, e.g., acne
• Serious blood clots

Keep an eye on these problems and report your health care professional when necessary.

Contraindications to the use of implants

Despite their efficacy and safety, use implants with caution if you have these health conditions:

• History of clotting (thrombosis)
• Have a positive pregnancy test
• Have a history of breast cancer
• Have undergone the removal of the implant due to over sensitivity.
• Have complained of abnormal vaginal bleeding
• Have liver problems, e.g., tumours and hepatitis etc...
• Have health problems, e.g., depression, epilepsy, obesity, hypercholesterolemia and diabetes etc...
• Taking various medications which may influence the progesterone (medicines for tuberculosis, epilepsy, HIV and antibiotics, e.g., rifampicin and rifabutin etc...

Bottom-line

Contraceptive implants offer safe and long-term contraception. However, as they are placed surgically inside the body, they have additional risks than the progesterone-only contraceptive pills. So, before using these pills, you should be fully aware of their potential disadvantages and risks. It is also a good habit to regularly visit a healthcare consultant for advice. Additionally, you should use all principles of safe sex, e.g., using a condom to prevent STIs.

If you are looking for permanent birth control, you should consult your doctor about vasectomy, the surgical process of sterilisation.

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