Birth Control Options for Women - Implant Contraception

Removing the Implant. When the time comes to remove the implants, the insertion site is again anesthetized and a small incision is made in the arm. Removal can be uncomfortable and is more difficult than the original procedure if scar tissue has formed over the implants. Removal usually takes 15 to 20 minutes, but may require more than one visit. (New implants with fewer rods appear to be much easier and faster to remove.) The implants' contraceptive action wears off a few hours after removal. Fertility is restored within a couple of weeks. If the user wishes, new implants can be inserted as soon as the old ones are removed.

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Candidacy for Levonorgestrel Implants

Levonorgestrel implants are comparable to tubal ligation in effectiveness. They are good choices for women who want to delay pregnancy for several years but hope to bear children later on. Although failure is rare, pregnancies do occur and are more likely in heavier and younger women.

Women should absolutely not use Norplant if they are pregnant or have the following conditions, or history of them:

Breast cancer.
Acute liver disease or tumors.
Blood clots.
Undiagnosed vaginal bleeding.

Those who should consider other methods first include the following:

Women who are breastfeeding. They should wait for six weeks after delivery to receive the implants. (One study suggested the newer Implanon system has no adverse affect on breast milk and so may be a safe option for breast-feeding mothers.)
Women at risk for breast cancer, blood clots, heart disease, diabetes, high blood pressure, liver disease, or stroke.
Women at risk for osteoporosis because of a link between bone calcium loss and progestin-contraceptives. (One study, however, reported that young girls who used the Norplant implants experienced increased bone density.)

Implants do not provide protection against sexually transmitted diseases, so women at risk for infection should also use a barrier contraceptive, or as an alternative to the implants.

Advantages of Levonorgestrel Implants

A study of women attending four family planning clinics reported that 92% of users of the implants were satisfied with the Norplant system. Another reported that the continuation rate after a year was better than that of combined oral contraceptive use. In general, studies indicate that at the end of five years, between 40% and 70% of recipients still used implants.

The advantages of the implants are as follows:

Levonorgestrel implants prevent pregnancy for up to five years.
They are easily reversible.
Like the IUD, the implants allow users to enjoy sex without worrying about taking a birth control pill every day, or inserting a diaphragm or cervical cap before sex begins.
Progestins may protect against uterine and ovarian cancer.