Implant fitting

What is a contraceptive implant?

A contraceptive implant is a small rod (about the size of a matchstick) which is placed under the skin of your arm. It slowly releases Etonogestrel, a hormone which stops ovulation (release of an egg), preventing pregnancy. Once it is in place, an implant is effective for 3 years.

How is the implant fitted?

The implant fitting procedure is explained in this short video:

You will need to book an appointment for your implant fitting by calling 01273 523 388, and on the day of your appointment we recommend that you allow for at least half an hour in clinic. We aim to see you at your appointment time but unfortunately sometimes there are unavoidable delays. Implants can also be fitted by some GP practices in Brighton and Hove.

The nurse or doctor will call you through and ask you some questions. This is to check that it is safe to fit the implant, and to answer any questions you have. If you haven’t already had a full sexual health screen you will be offered one. We offer all our patients a blood test for HIV and syphilis, and a swab for chlamydia and gonorrhoea.

A small area on your arm (around 3cm squared) will be numbed with an anaesthetic injection. This may sting, but will quickly become numb. The clinician will check the anaesthetic has worked before fitting the implant. As an alternative in some circumstances we can use a spray to numb the skin rather than an injection. The implant is fitted using a special device. It takes no more than a few minutes. You will not have any stitches, but a dressing will be put on your arm. This needs to be kept dry for 2 days after the procedure.

Please remember to wear clothes which are loose on the arm or can be removed for the procedure.

If you have further questions or concerns about the procedure you can book a telephone appointment to discuss any concerns before the procedure by ringing 01273 523 388. There are many things we can do to help make the whole process easier for you.

Phone line opening times:

*Phone lines are closed on Bank Holidays

When can an implant be fitted?

The implant can be fitted at any point in your menstrual cycle. If it is fitted on days 1-5 of your cycle (day 1 being the first day of your period), it is effective immediately. If it is fitted at any other point in your cycle it will take 7 days for the implant to become fully effective. You will need to use another form of contraception for this time if you have vaginal sex.

If there is a risk of pregnancy since your last period, the nurse or doctor fitting your implant may ask you to provide a urine sample for pregnancy testing on the day. You may be advised to repeat this after 21 days to make sure you are not pregnant.

If you are using another method of hormonal contraception, or have a copper intrauterine device (Cu- IUD or ‘copper coil’), you will be advised to continue using this until the implant is effective. The nurse or doctor who fits your implant will discuss this with you.

How effective is a contraceptive implant?

The implant is a very effective form of contraception. Once it is fitted and active (up to 7 days after fitting) it is 99.9% effective, meaning there is a less than 0.1% chance of becoming pregnant.

Depending on when in your menstrual cycle it is fitted, there may be a 7 day delay to the implant becoming fully effective. You will be advised to use another form of contraception like condoms until the implant is active. See the section below for more details about when an implant can be fitted.

The implant only protects against pregnancy, so we still advise condom use with new sexual partners and regular sexual health screening. The doctor or nurse may also offer you vaccinations and HIV PrEP (treatment to prevent HIV) depending on the type of sex you are having.

The effectiveness of the implant can be affected by certain medications. It is important that you tell your GP that you have an implant if you start any new medications.

What are the common side effects?

Bleeding

The main side effect of having a contraceptive implant fitted is often a change to your bleeding pattern.

Some people experience no bleeding at all while their implant is in place. As long as pregnancy is ruled out, this is not harmful, and your periods will return once the implant is removed. The implant does not affect your long-term fertility.

Some people experience light irregular bleeding, and some people experience constant bleeding. If your bleeding pattern suddenly changes, or if you are unhappy with your bleeding pattern, please contact us on 01273 523 388 as there are steps we can take to help manage this. A sudden change to your bleeding pattern may also be a sign of other issues, such as a vaginal infection, which would need to be ruled out.

Hormonal effects

You may experience some hormonal side effects such as mood changes, breast tenderness, acne or low libido. These effects are usually temporary and will resolve within a few months as your body becomes used to the hormones in the implant. If you are concerned about your side effects please contact us on 01273 523 388 as we will be able to discuss your options to manage it.

Infection

The risk of infection is rare after the first week of insertion. You will be shown how to keep your dressing clean and dry after the implant is fitted. If you think your implant has become infected, or if you are experiencing pain around the implant site, please phone us on 01273 523 388.

Breakage

It is very rare for an implant to break, the material used is flexible and designed to withstand pressure and movement. If you are concerned your implant has broken or moved, we will be happy to check this for you. Please phone us to book an appointment to check it on 01273 523 388.

Deep Implants

Occasionally, the implant may move slightly from the position where it was fitted. This is not usually a problem, however when it comes to removal, if the implant has moved deeper into the arm and we are unable to fully locate it, you may need to be referred to see a specialist in the clinic who will remove the implant using ultrasound guidance. There may be a slightly longer wait for this appointment.

How is the implant removed?

Although the implant is effective for 3 years it can be removed at any point if you no longer want it, for example if you are planning to get pregnant.

You will need to book an appointment for your implant removal by calling 01273 523 388, and on the day of your appointment we advise that you allow for about half an hour in clinic. Implants can also be removed by some GP practices in Brighton and Hove.

The nurse or doctor will call you through and ask you some questions. You will be offered another form of contraception if you are not planning to get pregnant, and you will have a chance to ask any questions. If you haven’t recently had a full sexual health screen you will be offered one.

A small area on your arm (around 3cm squared) will be numbed with an anaesthetic injection. This may sting, but will quickly become numb. The clinician will make a small incision (cut) in your arm where the implant is, and gently push the implant out. You will not have any stitches, but a dressing will be put on your arm. This needs to be kept dry for 5 days after the procedure.

Please remember to wear clothes which are loose on the arm or can be removed for the procedure.

If you have further questions or concerns about the procedure, you can book a telephone appointment before the procedure by ringing 01273 523 388. There are many things we can do to help make the whole process easier for you.

Advice for after an implant is fitted or removed

Please follow the guidance below:

1. Before your implant procedure, a small area on your arm will have been numbed with a local anaesthetic. The effects from this can last up to 2 hours. If it feels tender or bruised later on that day, take some shop bought pain killers (paracetamol or ibuprofen). Follow the instructions on the packet
2. Sometimes the local anaesthetic can make you feel sleepy or dizzy, so we ask you to stay at the clinic for a short time after your insertion/removal. If your procedure is at home the nurse will stay for a short while. If you notice any side effects, it is important that you do not drive until they wear off
3. After having an implant put in it is important to keep the area covered and dry for 2 days to help it heal
4. After having your implant taken out you will have some plaster strips across the wound to close it. These must kept dry and covered for 5 days
5. You may have a bandage on to help reduce the bruising. The bandage needs to be tight but not uncomfortable. Loosen if it’s too tight, or if your fingers swell up. You can take the bandage off 24-48 hours after your procedure, but you can keep it on for a little longer if you want to
6. There might be bruising around the implant site and a small scar, these will heal and fade quickly
7. If the area around the implant becomes red, hot, sore and itchy, then it is important to see a doctor. If you can’t do this, please phone 01273 523 388 for advice
8. Your implant contains a tiny amount of barium. This will show up on an x-ray and can be very useful in confirming the position of the implant
9. The implant lasts 3 years. Please book your next implant appointment 3 months before your implant runs out. You will be given a card with its expiry date on it. If you lose the card, call us on 01273 523 388 and we will tell you what the expiry date is
10. If you have any questions or concerns, please ring 01273 523 388 to discuss them with a nurse or doctor

Other frequently asked questions about contraceptive implants

How soon after having an implant removed can I get pregnant?

If you are planning to get pregnant, you can conceive as soon as the implant is removed. If you think you might be pregnant after having your implant removed, you need to do a pregnancy test three weeks after having unprotected sex.
Your normal periods should return within a few months after having an implant removed, but may come back sooner. If your periods do not return please seek advice from your GP or local sexual health clinic.

Can I bring someone with me?

You are welcome to bring someone with you for support. We will ask them to wait in the waiting area while we talk to you. This is clinic policy for everyone, and it gives you a space to ask any questions or discuss anything you may want to keep confidential. If you wish, we can then ask them to sit with you during the procedure. However, it is important that they do not obstruct the area the clinician is working in as this increases the risk of infection.

If you have or care for small children or babies, please arrange for childcare to avoid bringing them to your appointment. We will need you to lie still and relax. This can be hard to do when you are trying to look after children too.