Hormonal Implants

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hormonal implant

Hormonal implant

Hormonal implants are a type of birth control in the shape of a tiny tube that is placed under the skin of a woman’s upper arm. The implant prevents pregnancy and is effective for 3 years. The implant is about the size of a toothpick and made of a flexible plastic that contains a type of progestin hormone medicine called etonogestrel.

Out of 100 women using hormonal implants
Typical use: 1 or less women become pregnant icon representing less than 1 pregnant woman
Perfect use: 1 or less women become pregnant icon representing less than 1 pregnant woman

How does the hormonal implant work?

When placed under the skin, the tube(s) slowly releases small amounts of a progesterone hormone called “etonogestrel”. This suppresses the pituitary gland which stops the ovaries from releasing eggs. It must be inserted by a health care provider. Hormonal implants prevent pregnancy by:

  • Stopping the ovary from releasing an egg
  • Changing the cervical mucus (making it thicker) to prevent sperm from reaching the egg
  • Changing the lining of the uterus

Nexplanon® is a type of hormonal implant that is available in the United States. Other hormonal implants such as Norplant and Norplant II are no longer available in the US, but may be available in other countries.

When is the hormonal implant inserted?

The timing of insertion is important to prevent pregnancy. It’s usually inserted within the first seven days of your menstrual cycle or while you are on oral contraceptives or Depo-Provera®. Your health care provider will tell you when to make an appointment. A routine pregnancy test is typically done before the procedure.

When does the hormonal implant start to work?

The hormonal implant begins to prevent pregnancy about 24 hours after it is inserted as long as it is placed in your arm within the first 7 days of your menstrual cycle. Otherwise, you will need to use condoms for 7 days.

How long can the hormonal implant stay in my arm?

Nexplanon® works for up to 3 years. At this point if you are still happy with this type of birth control and your health care provider agrees that it is still a good option for you, the old hormonal implant can be removed and a new one inserted.

What is the procedure like?

Before the procedure: You will be asked to read and sign a consent form which gives your health care provider permission to insert the hormonal implant.

The procedure: Numbing medicine is placed around the inside of your upper arm (where the implant will be inserted) to lessen the discomfort. See photo. Next, using a special tool, your health care provider pushes the implant (tube) through a needle under the skin. This minor procedure takes about 5 minutes.

After the hormonal implant is inserted: Your health care provider will go over home-care instructions with you and will cover the site with 2 bandages. Keep the top bandage on for 24 hrs. Leave the smaller bandage on for 3-5 days, keeping it clean and dry.

How effective are hormonal implants?

Hormonal implants are more than 99% effective. This means that if 100 women use hormonal implants, less than 1 woman will become pregnant in a year. Hormonal implants do not protect against sexually transmitted infections (STIs). Condoms must be used.

Can you see or feel hormonal implants?

Usually, you can’t see the implant under your skin. However, in thin women, the outline of the implant may be visible. It may be possible to feel the hormonal implant in your arm, but it shouldn’t hurt.

Do hormonal implants have any other benefits besides protecting against pregnancy?

Yes. Hormonal implants can cause very light, or no, menstrual periods, less anemia (low number of red blood cells), and less menstrual cramps and pain.

Where can I get hormonal implants?

A health care provider must insert the hormonal implant. In the United States, the cost is about $280-$700. Some health insurance companies may cover part or all of the costs.

Can any woman get hormonal implants?

No. Hormonal implants cannot be used by women who:

  • Are pregnant
  • Have unexplained vaginal bleeding
  • Have a serious liver disease
  • Have had breast cancer

Some medications may lower the effectiveness of the implants. If you are taking medications such as certain anti-seizure medications, over-the-counter herbs, dietary supplements and /or vitamins, tell your health care provider.

Are there any side effects of hormonal implants?

There are some possible side effects of hormonal implants. They are different for every woman. The most common side effect is irregular menstrual bleeding. The bleeding is usually light and not a medical concern. If you have irregular menstrual bleeding and it is bothersome, call your health care provider.

If you experience heavy bleeding, keep track of the amount of pads/tampons you use and call your health care provider right away.

Other possible but uncommon side effects are:

  • Headaches
  • Weight gain (You can help maintain your weight by eating a healthy diet and getting regular exercise)
  • Scalp hair loss
  • Acne
  • Mood changes, such as depression or nervousness

Should I be worried if my menstrual period stops?

No. Some women stop having their menstrual periods after getting a hormonal implant. This is not a reason to worry. It just means that your ovaries are resting and not releasing an egg each month. When your ovaries don’t release an egg, the lining of your uterus does not get thicker. So there is no menstrual bleeding. Your menstrual cycles will return to the way they were, after the implant is removed. Talk to your health care provider and they’ll decide if you need a pregnancy test.

 What if I have problems with the hormonal implant?

Talk to your health care provider if you have questions or concerns, especially if you are having:

  • Very heavy or long menstrual periods
  • New painful headaches
  • Redness, swelling, or bleeding around or at the area where the implant was inserted

The hormonal implant isn’t the right option or choice for everyone. Did you know that you can have the hormonal implant removed anytime? Never, ever try to remove the implant by yourself! The implant MUST be removed by your health care provider!

What happens after 3 years when it’s time to take the hormonal implant out?

You’ll need to make an appointment with your health care provider.

 Will I be able to get pregnant after I have the implant removed?

Yes, you are fertile once the hormonal implant is removed.