The implant is the most effective method of contraception. It’s well over 99% effective. Fewer than 1 in 1,000 implant users will get pregnant in the first year of use.

If 100 sexually active women don’t use any contraception, 80 to 90 will get pregnant in a year.

The implant is a method of long-acting reversible contraception (LARC). LARC is very effective because it doesn’t depend on you remembering to take or use it.

The main way it works is to stop your ovaries releasing an egg each month (ovulation). It also:

• thickens the mucus from your cervix (entrance to the womb), making it difficult for sperm to move through it and reach an egg
• makes the lining of your uterus (womb) thinner to stop a fertilised egg implanting

Only a doctor, nurse or other healthcare professional trained to fit implants can insert the implant.

You can go to a contraception or sexual health clinic or to the doctor or nurse at a GP surgery.

Some midwives can insert an implant soon after you have a baby.

All treatment is free and confidential.

The implant is suitable for most people. The healthcare professional fitting your implant will need to ask about your own and your family’s medical history to make sure the implant is suitable for you. Do mention any illnesses or operations you’ve had.

An implant may not be suitable for you if:

• you think you might already be pregnant
• you don’t want your periods to change
• you take certain medicines

It may not be suitable if you have, or had in the past:

• breast cancer
• unexplained vaginal bleeding (for example, bleeding between periods or after sex)
• heart disease or stroke
• serious liver disease

Advantages?

• It works for 3 years
• You can use it if you’re breastfeeding
• Your fertility will return to normal as soon as the implant is taken out
• It may reduce heavy, painful periods
• It may improve acne for some people

Disadvantages?

• Your periods may change in a way that isn’t acceptable to you – see below
• You may get side effects like headaches, breast tenderness or mood changes
• You may get acne or your acne may get worse
• It won’t work if you use enzyme-inducing drugs – see below
• It requires a small procedure to insert and remove it
• An implant doesn’t protect you from sexually transmitted infections, so you may want to use condoms as well

• Very rarely, you may get an infection in your arm where the implant has been inserted
• Rarely, the implant may be inserted too deeply into your arm. It can be removed by an experienced healthcare professional
• Very rarely, the implant may be inserted into a blood vessel and may move to a different area of the body. If this happens, an operation is needed to remove it

If you can’t feel the implant in your arm, ask a healthcare professional to check it for you.

Research on the risk of breast cancer and hormonal contraception use is complicated and hasn’t given definite answers. The available research suggests that users of any hormonal contraception (including the implant) may be slightly more likely to be diagnosed with breast cancer, but the risk is small.

You start using an implant any time in your menstrual cycle if it’s certain you’re not pregnant.

If the implant is put in during the first 5 days of your period, you’ll be protected from pregnancy immediately.

If it’s put in on any other day, avoid sex or use additional contraception, such as condoms, for the first 7 days after it’s inserted.

The implant can be inserted any time after the birth.

If it’s inserted on, or before, day 21 you’ll be protected from pregnancy immediately.

If it’s inserted later than day 21, avoid sex or use additional contraception, such as condoms, for the first 7 days after it’s inserted.

An implant can be used safely while you’re breastfeeding and won’t affect your milk supply.

The implant can be inserted immediately after a miscarriage or abortion.

If it’s inserted on, or before, day 5 you’ll be protected from pregnancy immediately.

If it’s inserted later than day 5, avoid sex or use additional contraception, such as condoms, for the first 7 days after it’s inserted.

The implant is the size of a matchstick. It’s placed just under your skin, in the inner side of your upper arm.

A trained healthcare professional will give you a local anaesthetic to numb the part of your arm where the implant will go, so it won’t hurt.

It only takes a few minutes to insert and feels like having an injection. You won’t need stitches.

After it’s been inserted, the healthcare professional will check your arm to make sure the implant is in the correct place. You’ll be shown how to feel the implant with your fingers, so you can check it’s in place.

The area may be tender for a day or two and may be bruised and slightly swollen. The healthcare professional will put a dressing on it to keep it clean and dry and to help reduce any bruising. Keep this dressing on for a few days and try not to knock the area.

Don’t worry about knocking the implant once the area has healed. It shouldn’t break or move around your arm. You’ll be able to do normal activities and you won’t be able to see it.

You don’t need a vaginal examination or cervical screening (smear) test to have an implant inserted.

An implant can be left in place for 3 years. It can be removed sooner if you want to stop using it.

A specially trained healthcare professional must take it out.

• They’ll feel your arm to locate the implant.
• They’ll give you a local anaesthetic injection in the area where the implant is.
• They’ll make a tiny cut in your skin and gently pull the implant out.
• They’ll put a dressing on the arm to keep it clean and dry and to help reduce any bruising. Keep this dressing on for a few days.

It usually only takes a few minutes to remove an implant. If the implant has been inserted correctly, it shouldn’t be difficult to remove.

Occasionally, an implant is difficult to feel under the skin and it may not be so easy to remove. If this happens, you may be referred to a specialist centre to have it removed with the help of an ultrasound scan.

If you want to carry on using an implant, you can get a new one at the same time. You’ll then continue to be protected from pregnancy.

Some medicines may make an implant less effective.

These include some of the medicines used to treat HIV, epilepsy and tuberculosis (TB), and the complementary medicine St John’s Wort. These are called enzyme-inducing drugs. If you take these medicines, talk to your healthcare professional. Consider changing to a contraception method that won’t be affected by the medicines you’re taking.

Always tell your healthcare professional that you’re using an implant if you’re prescribed any medicines.

The implant is not affected by common antibiotics, diarrhoea or vomiting.

It’s important to have your implant changed at the right time. If it isn’t, you won’t be protected from pregnancy. If you have sex without using another method of contraception and don’t want to get pregnant you may need to consider using emergency contraception.

Your bleeding will probably change. It’s common for it to be unpredictable and it may change at any time over the 3 years the implant lasts.

• Most implant users will have irregular and unpredictable bleeding
• Sometimes bleeding stops completely
• A few implant users will have bleeding that’s more frequent or lasts longer

These changes may be a nuisance but they’re not harmful. If you have bleeding that’s a problem for you in the first few months after starting the implant, there’s about a 1 in 2 (50%) chance that this will improve over time.

If you have bleeding that’s a problem for you at any time, talk to your healthcare professional. They may be able to give you some additional hormone or medicine that can help control the bleeding. They may also check the bleeding isn’t due to other causes, such as an infection.

If you want to stop using the implant, a healthcare professional can remove it. Your periods and fertility will return to normal and it’s possible to get pregnant before you have your first period after stopping the implant.

If you don’t want to get pregnant, use another method of contraception from the day your implant is removed.

If you want to try for a baby, start pre-pregnancy care such as taking folic acid and stopping smoking. Ask your healthcare professional for further advice.

No, you don’t need to stop using the implant if you’re having an operation, but do let your doctor know that you’re using it.

Each implant lasts for 3 years and will then need to be replaced.

If you have no medical problems, you can use the implant until menopause, when contraception is no longer needed.

You only need to go to the clinic or your GP surgery if you have any problems with your implant or when it needs to be replaced.

If you have any problems, questions or want the implant removed, contact your healthcare professional.

The implant is a highly effective method of contraception. If you haven’t taken any medicine that might make the implant less effective and you’ve had it changed on time, it’s very unlikely that you’ll get pregnant.

If you think you might be pregnant, do a pregnancy test or speak to your healthcare professional as soon as possible.

Using the implant won’t affect a pregnancy test. If you do get pregnant while you’re using the implant, there’s no evidence it will harm the pregnancy. The implant should be removed if you want to continue with the pregnancy.