Contraceptive implants are a long-term birth control method. They're also called long-acting reversible contraception, or LARC.
A contraceptive implant is a flexible plastic rod about the size of a matchstick that is placed under the skin of the upper arm. The implant releases a low, steady dose of the hormone progestin.
Progestin prevents pregnancy by pausing ovulation. And it thickens the mucus of the cervix. This makes it hard for sperm to reach an egg. Progestin also thins the lining of the uterus. If sperm do reach an egg, this makes it harder for the fertilized egg to attach to the uterus.
Contraceptive implants are effective, long-term birth control. Benefits of the implant include:
But contraceptive implants aren't right for everyone. Your care team might suggest another birth control method if you have:
The label for the active ingredient in the implant, etonogestrel, says it shouldn't be used by people with a history of blood clots. The warning comes from studies of combination birth control pills that also use progestin plus estrogen. But those risks may be due to the estrogen alone. Because the implant only uses progestin, it isn't clear if it actually carries any risk of forming blood clots.
Talk to your care team if you might be at risk for blood clots. This includes a history of blood clots in your legs or lungs, also called pulmonary embolus. They will know if the implant is a safe method for you.
Also, tell your care team if you have a history of:
Certain medicines and herbal products may lower the levels of progestin in your blood. This means the implant might not prevent pregnancy as well. Medicines known to do this include certain seizure medicines, sedatives, HIV medicines and the herb St. John's wort. If you take any of these medicines, talk with your care team about your birth control options.
The contraceptive implant doesn't protect against sexually transmitted infections.
Fewer than 1 in 100 women who use the contraceptive implant for one year will get pregnant. But if you do conceive while using the implant, there's a higher chance the pregnancy will be ectopic. This means the fertilized egg implants outside the uterus, often in a fallopian tube. But the risk of ectopic pregnancy is still lower than for those who are having sex without birth control. That's because the rate of pregnancy while using the implant is so low.
Side effects associated with contraceptive implants include:
Your care team will look at your whole health before moving forward with scheduling the procedure. If all looks safe, they will decide the best date to place the implant. This is based on your period cycle and any birth control method you're using.
You might have to take a pregnancy test before the implant can be placed. Once the implant is in, it's a good idea to use condoms or another nonhormonal backup method of birth control for the first week just to be safe.
You might not need backup birth control if you have the contraceptive implant placed:
You'll have the contraceptive implant placed at your care provider's location. The actual procedure takes just a minute or so, though preparation will take a bit longer.
You'll lie on your back and be awake. The arm that will get the implant will either be straight out to the side, or bent at the elbow and placed near your head. These positions show the inside of your upper arm.
Your provider will find a groove between the muscles on the inside of your upper arm. Then, you'll get a shot of local anesthetic to numb the area. Last, the device will be inserted with an applicator just beneath your skin. If the implant gets inserted too deeply, removal can be tricky.
Your care provider will feel your arm to check the placement of the implant and have you do the same. An ultrasound or X-ray might be needed to check that the device got placed correctly.
A small bandage will cover the placement site. Also, a pressure bandage might be applied to lessen bruising. You can take off the pressure bandage in 24 hours. But keep the small bandage on and keep the area clean for 3 to 5 days.
It's common to have some bruising, pain, scarring or bleeding at the placement site.
Contact your care team if you notice:
The contraceptive implant can prevent pregnancy for up to three years. It must be replaced at the three-year mark to continue protecting against unplanned pregnancy.
Your care team might suggest removing the contraceptive implant if you develop:
To remove the device, your provider will give you a shot of local anesthetic in your arm beneath the implant to numb the area. Next, a small cut will be made in the skin of your arm and the implant pushed to the surface. Once the tip of the implant can be seen, it will be grasped with forceps and taken out.
After the contraceptive implant is removed, the cut will be covered with a small bandage and pressure bandage. The removal procedure typically takes less than five minutes.
If you want, a new implant can be placed as soon as the original one is removed. Plan to use another type of birth control right away if you don't have a new contraceptive implant placed.