Contraception- The Implant

May 3, 2017 Contraception

Hello all!

Last week we discussed the basics of birth control and most importantly the pill. This week we are still focused on contraception but a different form. As I mentioned last week the pill is not for everyone. For those who might forget to take the pill or who just want the convenience of not having to remember to take the pill everyday the implant, otherwise known as Nexplanon or Implanon, might be a more feasible option.

What is the implant? In essence it is a small flexible rod that is implanted under your skin. It should be invisible once inserted into the upper arm. The implant it is about the size of a matchstick and should not impede your movement in anyway. It is tiny and a doctor or nurse can implant it for you when you visit your OBGYN or remove it should you wish to have it taken out. There may be some bruising when it is implanted but that is to be expected. For an application or removal your doctor should numb the area of your arm where the implant was placed or where they plan to place it. 

Essentially it works in the same way as the pill except the primary hormone released by the implant is progesterone. Progesterone works in three ways to stop pregnancy. We went over the basic elements of how the pill prevents pregnancy last week but we can delve further into it here.

The first way that progesterone works is by thinning out the lining with in the uterus. In order for an egg to be fertilised and become a fetus the egg, which has been released from the fallopian tubes, will attach to the uterine lining. Without enough lining a pregnancy cannot continue and the lining and egg will be expelled with the next menstruation.

Progesterone also thickens the mucus found on the cervix which helps to prevent sperm from reaching an egg. The less sperm that get through to the cervix the les likely you are to become pregnant.

Perhaps the most important way progesterone works to stop you from getting pregnant is to halt the release of eggs from the fallopian tubes. Usually an egg is released and moves down towards the uterus. Once there, if there are sperm present, it is possible for sperm to reach the egg and fertilise it. After that the cells begin the replicate DNA, grow and then split. That is the most basic description of cell replication that I could think of but I am getting ahead of myself. We can discuss the ins and outs of birth and how a baby is created soon. Without an egg none of this can happen.

To recap, pregeserone stops eggs from being released. Should an egg be released, sperm have to find their way through a thick layer of mucus in the cervix in order to fertilise the egg. Should a sperm manage to get through and there happens to be an egg present for fertilisation the lining of the uterine wall should be too thin to cultivate growth and thus you avoid pregnancy. In fact the implant is 99% effective. You could even say that per user it is more effective because the element of human mishap is removed, in other words you don’t forget to take it everyday. Once the implant is in, you can forget that it is there and it will continue to prevent pregnancy for up to 4 years. Yes, that is 4 years of not having to remember to take a pill at the same time every day.

For those who might be concerned that this “get it and forget it” contraception cannot be removed, let me reassure you now; should you at any time wish to have it removed or you wish to begin trying for a baby your doctors office should be able to do this for you. It will require consultation for both inserting the implant and removing it but once it is implanted you can continue on worry free. Some women, less than 2%, have a negative reaction to the application and removal of the implant.

The most common side effect of the implant is unpredictable bleeding. For some women, the unusual bleeding patterns improve over time. Some women have less menstrual pain while using the implant. Sometimes bleeding stops completely. Other common side effects include mood changes, headaches, acne, and depression. There has been reported weight gain while using the implant, but it is not clear whether it is related to the implant. There is also the possibility, though very small, that if you do become pregnant while using the implant you will have a higher chance of an ectopic pregnancy. keep in mind that the possibility that you will get pregnant at all is very small.

It is important to keep in mind that the implant will not protect you from STD’s. Just like the pill, the implant cannot block the transference of STD’s from one sexual partner to another. For this you will need to keep condoms on hand. whether you choose to use male or female condoms is up to you but both will work. Also, the implant cannot stop you from contracting any STDs through blood transfusions.

So there you have it, the ins and outs of the implant. Stay tuned for next weeks topic; the IUD.

Until next time!