Contraceptive implant

Effectiveness: Over 99% effective at preventing pregnancy - one of the most effective methods there is.

Fit and forget: Once you've got one, you don't need to remember to take or use contraception for 3 years.

Periods: May be irregular, stop or last longer. May help with heavy, painful periods.

STI protection: No. Use external condoms or internal condoms to help protect yourself from STIs.

Hormones: Yes. The implant releases the hormone progestogen.

If 100 sexually active women don’t use any contraception, 80 to 90 will get pregnant in a year.

The implant is the most effective method of contraception. It's well over 99% effective. Fewer than 1 in 100 implant users will get pregnant in the first year of use.

The implant is a method of long-acting reversible contraception (LARC). LARC is very effective because it doesn’t depend on you remembering to take or use it.

Can anything make an implant less effective?

Some medicines may make an implant less effective. These include some of the medicines used to treat HIV, epilepsy and tuberculosis (TB), and the complementary medicine St John’s Wort. These are called enzyme-inducing drugs. If you take these medicines, it'll be recommended that you use additional contraception, such as condoms, or that you change to a different method of contraception.

Always tell your healthcare professional that you’re using an implant if you’re prescribed any medicines.

The implant isn't affected by common antibiotics, diarrhoea or vomiting.

It's important to have your implant changed at the right time. If it isn't, you won't be protected from pregnancy. If you have sex without using another method of contraception and don’t want to get pregnant, you may need to consider using emergency contraception.

The implant is suitable for most people. The healthcare professional fitting your implant will need to ask you about your own and your family’s medical history to make sure the implant's suitable for you. You should tell them about any illnesses or operations you’ve had.

An implant may not be suitable for you if:

• you think you might already be pregnant
• you don't want your periods to change
• you take certain medicines.

It may not be suitable if you have, or had in the past:

• breast cancer
• unexplained vaginal bleeding (for example, bleeding between periods or after sex)
• heart disease or stroke
• serious liver disease

How long can I use the implant for?

Each implant lasts for 3 years and will then need to be replaced.

If you have no medical problems, you can use the implant until menopause when contraception is no longer needed.

• It works for 3 years.
• It may reduce heavy, painful periods.
• You can use it if you're breastfeeding.
• Your fertility will return to normal as soon as the implant is taken out.
• It may improve acne for some people. 

• Your periods may change in a way that isn't acceptable to you (see Periods and fertility).
• You may get side effects like headaches, breast tenderness and mood changes.
• You may get acne or your acne may get worse.
• It won't work if you use enzyme-inducing drugs (see Effectiveness).
• It requires a small procedure to insert and remove it.
• An implant doesn't protect you from sexually transmitted infections, so you may need to use condoms as well.

Very rarely, you may get an infection in your arm where the implant's been inserted.

Rarely, the implant may be inserted too deeply into your arm. It can be removed by an experienced healthcare professional.

Very rarely, the implant may be inserted into a blood vessel and may move to a different area of the body. If this happens, an operation is needed to remove it.

If you can't feel the implant in your arm, ask a healthcare professional to check it for you.

Research on the risk of breast cancer and hormonal contraception is complicated and hasn't given definitive answers. Available research suggests that using the implant doesn't appear to increase the risk of breast cancer.

The main way it works is to stop your ovaries releasing an egg each month (ovulation). It also:

• thickens the mucus from your cervix (entrance to the womb), making it difficult for sperm to move through it and reach an egg
• makes the lining of your uterus (womb) thinner to stop a fertilised egg implanting.

How will an implant affect my periods?

Your bleeding will probably change. It's common for it to be unpredictable and it may change at any time over the 3 years the implant lasts.

• Most implant users will have irregular and unpredictable bleeding.
• Sometimes bleeding stops completely.
• A few implant users will have bleeding that's more frequent or lasts longer. 

These changes may be a nuisance but they're not harmful.

If you have bleeding that's a problem for you in the first few months after starting the implant, there's about a 1 in 2 (50%) chance that this will improve over time. 

If you have bleeding that's a problem for you at any time, talk to your healthcare professional. They may be able to give you some additional hormone or medicine that can help control the bleeding. They may also check that the bleeding isn't due to other causes, such as an infection.

What if I want to stop using the implant or try to get pregnant?

If you want to stop using the implant, a healthcare professional can remove it. 

Your periods and fertility will return to normal and it’s possible to get pregnant before you have your first period after stopping the implant.

If you don’t want to get pregnant, use another method of contraception from the day your implant is removed.

If you want to try for a baby, start pre-pregnancy care such as taking folic acid and stopping smoking. Ask your healthcare professional for further advice.

What if I think that I'm pregnant?

The implant's a highly effective method of contraception. If you haven't taken any medicine that might make the implant less effective and you've had it changed on time, it's very unlikely that you'll get pregnant.

If you think you might be pregnant, do a pregnancy test or speak to your healthcare professional as soon as possible. Using the implant won't affect a pregnancy test.

If you do get pregnant while you're using the implant, there's no evidence it'll harm the baby. The implant should be removed if you want to continue with the pregnancy.

I've just had a baby. Can I use an implant?

The implant can be inserted any time after the birth.

If it’s inserted on, or before, day 21 you’ll be protected from pregnancy immediately. If the implant is inserted later than day 21, you’ll need to avoid sex or use additional contraception, such as condoms, for 7 days.

An implant can be used safely while you're breastfeeding and won't affect your milk supply.

Can I use an implant after a miscarriage or abortion?

The implant can be inserted immediately after a miscarriage or abortion.

If it's inserted on, or before, day 5 you'll be protected from pregnancy immediately. If the implant's inserted later than day 5, you'll need to avoid sex or use additional contraception, such as condoms, for 7 days.

Only a doctor, nurse or other healthcare professional trained to fit implants can insert the implant.

You can go to a contraception or sexual health clinic or to the doctor or nurse at a general practice. See How to get help with your sexual health.

Some midwives can insert an implant soon after you have a baby.

All treatment is free and confidential.

When can I start using an implant?

You can have an implant fitted at any time in your menstrual cycle if it's certain that you're not pregnant.

If the implant is put in during the first 5 days of your period, you'll be protected from pregnancy immediately.

If the implant is put in on any other day, you won't be protected from pregnancy for the first 7 days after it's been inserted. You'll need to avoid sex or use additional contraception, such as condoms, during this time.

How's an implant inserted?

The implant is the size of a matchstick. It’s placed just under your skin in the side of your upper arm.

A trained healthcare professional will give you a local anaesthetic to numb the part of your arm where the implant will go, so it won’t hurt.

It only takes a few minutes to insert and feels like having an injection. You won’t need stitches.

After it’s been inserted, the healthcare professional will check your arm to make sure the implant's in place. You’ll be shown how to feel the implant with your fingers, so you can check it’s in place.

The area may be tender for a day or two and may be bruised and slightly swollen. The healthcare professional will put a dressing on it to keep it clean and dry and to help reduce the bruising. Keep this dressing on for a few days and try not to knock the area.

Don’t worry about knocking the implant once the area has healed. It shouldn’t break or move around your arm. You’ll be able to do normal activities and you won’t be able to see it.

You don’t need a vaginal examination or cervical screening (smear) test to have an implant inserted.

How's an implant removed?

An implant can be left in place for 3 years. It can be removed sooner if you want to stop using it.

A specially trained healthcare professional must take it out. They'll feel your arm to locate the implant. They’ll give you a local anaesthetic injection in the area where the implant is. They’ll make a small cut in your skin and gently pull the implant out.

They’ll put a dressing on the arm to keep it clean and dry and to help reduce any bruising. Keep this dressing on for a few days.

It usually only takes a few minutes to remove an implant. If the implant's been inserted correctly, it shouldn’t be difficult to remove.

Occasionally, an implant is difficult to feel under the skin and it may not be so easy to remove. If this happens, you may be referred to a specialist centre to have it removed with the help of an ultrasound scan.

If you want to carry on using an implant, you can get a new one inserted at the same time. You’ll then continue to be protected from pregnancy.

If I need to have an operation, should I stop using the implant?

No. It's not necessary to stop using the implant if you’re having an operation. However, it’s always recommended that you mention you're using it.

How often do I need a check-up?

You only need to go to the clinic or your general practice if you have any problems with your implant or when it needs to be replaced.

If you have any problems, questions or want the implant removed, contact healthcare professional.