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Contraceptive Implant - Indications, Contraindications, Placement, and Removal

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A contraceptive implant is placed to prevent pregnancy. This article explains contraceptive implants' advantages, disadvantages, procedures, and risks.

Written by

Dr. Asha. C

Medically reviewed by

Dr. Monica Mathur

Published At March 6, 2023
Reviewed AtMarch 6, 2023


There are different types of contraceptive methods available these days, like contraceptive pills, patches, rings, and implants. A contraceptive implant or birth control implant is a tiny thin rod that is placed under the skin and produces hormones that help to prevent pregnancy. This implant provides protection from pregnancy for three to five years, depending on the implant used. This implant has many benefits and complications.

What Is a Contraceptive Implant?

A contraceptive implant is a small flexible rod of plastic about the size of a matchstick. The healthcare professionals implant the rod under the skin of the upper arm. After implantation, this releases a low dose of progestational hormone to thin the endometrium (the lining of the uterus) and thicken cervical mucus. This implant helps to suppress ovulation and protect a person from pregnancy for five years. As these implants are radio-opaque, they can be seen in an X-ray, making location identification of the implant helpful. If an individual decides to get pregnant or does not want to have the implant placed anymore, they can reach the doctor. The doctors will remove the implant whenever required. After removing the implant, pregnancy is possible.

How Does the Contraceptive Implant Work?

The contraceptive implant is a small, thin, and flexible rod about the size of a matchstick. This rod is inserted under the skin of the upper arm by a healthcare professional, and then it starts to release a low dose of the progestin hormone to prevent getting pregnant. The hormone released from the birth control implant helps in preventing pregnancy in two ways:

  • Progestin helps to thicken the mucus on the cervix. This stops sperm from reaching the egg. If the sperm does not meet the egg, pregnancy is not possible.

  • Progestin can also halt the ovulation process, so there is no egg produced to fertilize. Without an egg released, becoming pregnant is not possible.

What Are the Contraindications of Contraceptive Implants?

Contraceptive implants are beneficial to many women as it is a long-term contraceptive, and it has various advantages, like easy removal whenever needed and can get pregnant after the removal. However, these implants are contraindicated for a few women with the following conditions:

  • If women do not want their periods to change.

  • Taking other medications that can affect the contraceptive implants.

  • History of stroke or heart disease.

  • History of breast cancer or having breast cancer.

  • History of liver diseases.

  • Have bleeding after sex or between periods.

  • Have serious blood clot disorders.

  • Allergic to any components of the contraceptive implant.

What Are the Advantages of Having a Contraceptive Implant?

There are many advantages of placing a contraceptive implant, including:

  • It does not interrupt during sex.

  • It is an ideal option when a person cannot use estrogen-based contraception, such as contraceptive patches, pills, and vaginal rings.

  • It is safe during breastfeeding.

  • As soon as the implant is removed, women can get pregnant.

  • It might reduce period pain and heavy bleeding.

  • It works for three to five years.

What Are the Disadvantages of Contraceptive Implants?

Even though contraceptive implants have many advantages, they have some disadvantages, which are listed below:

  • Initially, after placing the implant, a person may experience side effects like nausea, headache, breast soreness, and mood swings.

  • Chances of getting acne.

  • There are chances of delayed periods or absence of periods.

  • It will not protect from sexually transmitted diseases, so additional contraception like condoms is required.

How Is a Contraceptive Implant Placed?

A contraceptive implant is implanted by a doctor; this procedure typically takes just a minute, though preparation will be a bit longer. The person who gets the implant is asked to lie on their back. The arm in which the implant is placed is bent at the elbow and placed near the head. Local anesthesia is given on the inner side of the arm. The doctor will find a groove between the triceps and bicep muscles on the inner side of the upper arm, and then the device is inserted beneath the skin using an applicator. Doctors usually insert it superficially for easy locating and removal during removal. If the device is inserted deeply, removal will be difficult.

After placing the contraceptive implant, the doctors will touch and feel the area of the implant to confirm its presence. If necessary, they may use an X-ray or ultrasound to confirm the correct placement of the implant. Then the doctors will cover the site of insertion with a small bandage which should be kept clean for three to five days. A pressure bandage may also be applied to minimize bruising, which can be removed after 24 hours. Some degree of bruising, scarring, pain or bleeding may be experienced that is common.

How Is a Contraceptive Implant Removed?

The contraceptive implant can prevent pregnancy for three to five years. It must be removed and replaced after that to continue protection from unintended pregnancy. Earlier removal of the contraceptive implant may be required if an individual develops heart disease, jaundice, uncontrolled high blood pressure, or severe migraine.

The removal of the implant normally takes only five minutes. For removal of the implant, the doctor will inject a local anesthetic in the arm near the implant and make a small incision in the skin, and take out the implant with forceps. After removing the implant, the incision is closed, and a pressure bandage is applied. A new implant can be placed immediately after the removal.

What Are the Risks of Contraceptive Implant Placement?

In rare cases, women get pregnant even after using the contraceptive implant. If it happens so, there is a higher chance of pregnancy being ectopic (the fertilized egg implants outside the uterus, commonly in a fallopian tube). The side effects associated with implants include:

  • Low sex drive.

  • Stomach or back pain.

  • Increased risk of noncancerous ovarian cysts.

  • Mood swings and depression.

  • Changes in menstruation.

  • Absence of menstruation (amenorrhea).

  • Dizziness.

  • Headaches.

  • Nausea.

  • Stomach upset.

  • Sore breasts.

  • Vaginal dryness and inflammation.

  • Weight gain.

  • Chances of interaction with other medications.


Contraceptive implants are used by women to prevent unwanted pregnancies. This is a small, flexible, and thin rod placed in the upper arm. When implanted, it will help to prevent pregnancy for three to five years, depending on the type of implant used. This method has many advantages as well as disadvantages, so it is important to discuss it with the doctor before implanting it.

Frequently Asked Questions


Is a Pill Better Than an Implant for Contraception?

Both pill and implant have their advantages and disadvantages. The choice of pill or implant depends on medical history and individual preferences. Oral contraceptive pills contain synthetic hormones such as estrogen and progestin that prevent ovulation. The benefits of the pill include reducing the risk of endometrial cancer, improving acne, and regulating the menstrual cycle. Missing the pill can reduce its effectiveness. The contraceptive implant is highly effective, with a failure rate of less than one percent. Unlike the pill, the implant does not require daily attention. Implants cause spotting or irregular bleeding in some women. Implants cause side effects such as weight gain, headaches, and mood changes. Both the pill and implant are effective, with their pros and cons.


What Are the Two Types of Contraceptive Implants?

The two types of contraceptive implants are etonogestrel and levonorgestrel implants. Etonogestrel implants are inserted under the skin of the upper arm. They release a synthetic hormone called etonogestrel, which is a type of progestin. They act by thickening the cervical mucus, thinning the uterus lining, and preventing ovulation. Levonorgestrel implants have two small rods that are also inserted under the skin of the upper arm. They release a synthetic hormone called levonorgestrel, a type of progestin. They are long-lasting and also have the same mechanism of action as etonogestrel. Both types are effective, with a failure rate of less than one percent.


What Are the Side Effects of Contraceptive Implants?

Contraceptive implants are a form of long-acting reversible contraception that releases a hormone called progestin. Though they are highly effective at preventing pregnancy, they can cause side effects in some women. The side effects of contraceptive implants are irregular bleeding patterns. The other symptoms include spotting,  prolonged bleeding, and irregular bleeding. Some may not have bleeding. These changes in bleeding patterns are not harmful. The other side effects include weight gain, acne, nausea, headache, mood changes, abdominal pain, and breast tenderness. In rare cases, implants can cause liver tumors or blood clots. Women with a history of liver disease should not use contraceptive implants.


Which Is the Best Contraceptive Method?

The best contraceptive method depends on various factors such as lifestyle, medical history, age, and personal preferences. There are both hormonal and non-hormonal methods of contraception available in the market, with their advantages and disadvantages. The hormonal methods are patches, birth control pills, vaginal rings, and hormonal implants. Non-hormonal methods include cervical caps, condoms, and diaphragm. The non-hormonal methods work by blocking the entry of sperm from reaching the egg. The non-hormonal methods are safe and have no side effects. The non-hormonal methods are less effective than hormonal methods. Intrauterine devices such as T-shaped copper and plastic devices and hormonal implants are also popular choices among women. Intrauterine devices offer protection against pregnancy and are highly effective.


Can One Get Pregnant With an Implant?

Yes, there are chances that one can get pregnant with an implant. The contraceptive implant is effective in preventing pregnancy, with less than one percent failure rate. The main reason for pregnancy with an implant is improper placement of the device. Also, if the implant moves from its original position, it can become less effective. Certain medical conditions and obesity can also affect the efficacy of hormonal birth control.


How Safe Is a Hormonal Implant?

Hormonal implants are very effective and safe in preventing pregnancy. Hormonal implants are convenient and do not require daily attention or care like other methods of contraception. Hormonal implants also have risks and side effects. The side effects are usually mild and go away after a few days of usage. The hormonal implants can cause blood clots. Women with sexually transmitted infections should use non-hormonal methods of contraception along with hormonal methods of contraception. Hormonal implants do not protect against sexually transmitted infections. Hormonal implants are safe when used correctly.


Are Contraceptive Implants Painful?

The contraceptive implants can cause discomfort or pain. The level of pain varies from person to person. The pain is usually sharp and lasts for a few seconds. The pain experienced during the insertion of implants is managed with local anesthesia. Though they cause initial pain and discomfort, they are safe and effective. The insertion of contraceptive implants causes some pain, but it can be managed with local anesthesia or pain relievers. Overall, it is a safe and effective form of birth control.


How to Remove a Contraceptive Implant?

Removing a contraceptive implant is a medical procedure performed by a doctor or a trained healthcare professional. The implant is carefully removed by making a small incision in the arm. Proper protocols should be followed to remove the implant to avoid damage or infection to the surrounding tissue. The best method of removal of the implant is determined by a healthcare professional. The area is given local anesthesia, and a small incision is made. The implant is removed with a specialized tool or forceps. Removing a contraceptive implant does not immediately restore fertility.


How Do Contraceptive Implants Cause Infertility?

The hormonal contraceptives lead to irregular menstrual cycles and a decreased ability to conceive. Contraceptive implants cause infertility by damaging the uterus lining. The progestin causes the endometrial lining to thin, which makes the fertilized egg difficult to implant, leading to infertility. Contraceptive pills also impact the quality of the woman’s eggs. Synthetic progestin is also linked to oxidative stress that damages the woman's egg DNA and its quality. So, the contraceptive implants disrupt the hormonal balance and affect the quality of the egg.


What Is the Life of a Contraceptive Implant?

Contraceptive implants are very effective in preventing pregnancy. But they do not protect against sexually transmitted infections. Over time, the effectiveness of the contraceptive pills decreases, especially if not inserted properly. In some cases, the implant is removed before three years.


What Is the Success Rate of the Contraceptive Implant?

The contraceptive implant has a success rate of over 99 percent in preventing pregnancy. The contraceptive implant releases synthetic hormones to prevent pregnancy for up to three years. The success rate of the contraceptive implant is high, with less than one percent of the positive rate for pregnancy in the initial year of use. Out of 100 women, less than one will become pregnant.


How Is the Contraceptive Implant Inserted?

The implant insertion takes only a few minutes. Before insertion, any history of pregnancy or potential risks are noted. The area is first cleaned, and local anesthesia is given to numb the area. Then, a special applicator is used to insert the implant under the skin. After insertion, the insertion site is kept clean and dry to prevent infection. The implant is allowed to remain in place for up to three years.
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Dr. Monica Mathur
Dr. Monica Mathur

Obstetrics and Gynecology


birth control methodscontraceptive implant
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