Birth Control Options for Women - Implant Contraception

Highlights	Injected Contraception	Emergency Contraception
Introduction	Intrauterine Devices (IUDs)	Female Sterilization
Oral Contraception	Spermicidal and Barrier Contraception	Resources
Implant Contraception	Natural Family Planning Methods	References

Implant Contraception

Progestin implant contraception uses rods that are inserted under the skin and continuously release tiny amounts of progestin into the bloodstream.

The standard implant has been the Norplant system, which uses the hormone levonorgestrel. This implant contraception consists of six flexible plastic rods, each about the size of a cardboard match. The Norplant system can generally remain in the arm for five years or be removed earlier if the recipient wishes. It is currently off the market.

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Newer systems (Norplant II, Jadelle, Implanon) use fewer implants. The Norplant II and Jadelle system uses two rods and Implanon uses only one. All are proving to be safe and effective. A 2000 study on Implanon, which uses the progestin ketodesogestrel, reported that it was less costly than oral contraceptives, injected progestins (Depo-Provera), and Norplant. It was also more effective than Depo-Provera in preventing pregnancy.

Insertion of Implants. To ensure that a potential Norplant recipient is not pregnant at the time of insertion, the implants are usually inserted during the first seven days of her period. The typical procedure is as follows:

The rods are inserted by a specially trained health care provider under the skin of the upper inside part of the non-dominant arm.
After injecting the insertion site with a local anesthetic, the health care provider makes a small incision in the arm and places the implants under the skin with a trocar, a sharp-tipped instrument that resembles a large ballpoint pen. There are no stitches.
A bandage is then placed over the wound and remains there for a few days to allow the site to heal.
The entire procedure takes about 10 minutes and is painless, except for any discomfort caused by the anesthetic injection.
For a few days afterward the recipient may also experience bruising, swelling, and discomfort at the insertion site.
The implants begin to work within eight to 24 hours of the procedure, but the woman should use additional contraceptive protection for a week or two, depending on the physician's recommendation.

Implants do not require maintenance of any kind and do not affect the use of the arm once the insertion site has healed. They can be felt if the insertion site is touched, and their outline may be visible in thin arms. A return visit to the health care provider within three months of insertion, followed by yearly check-ups, allows the recipient's progress to be monitored.