Contraceptives

This second post on contraceptive implants is packed with information so it’s a bit long but it IS timely, given the decision by the Department of Health in the UK to introduce a national campaign that aims to make young people more aware of contraceptive options. ‘Doctors will be told to advise young women they should not automatically opt for oral contraceptives and instead think about using newer methods that last between three months and five years.’ reports the Daily Telegraph. Women will be told to consider injections and implants instead of the Pill, in an attempt to reduce the number of unwanted pregnancies.

Regardless of country, every women has the right to be offered and counselled on ALL methods of contraception, with no bias implied unless individual medical history prevents some types of contraceptive from being safely prescribed. In Britain, it seems that for 3/4 of women, this does not happen (APPG survey).  Surely, for a public campaign, the focus should be on educating and empowering everyone to make their OWN informed choice according to their own circumstances, not steering them to ‘long term’ contraception with contraceptive implants and injections?

SO, to inform and empower you, here are a few FAQ’s and answers to some common misunderstandings about the ‘new generation’ contraceptive implants :
(read the earlier post on the effectiveness of contraceptive implants and how they work)

If you have a specific question, do a quick scroll down to find the answer.

Do I have to undergo any pelvic or breast exam before I use an implant? NO
Do I need a blood test? NO
How long do the new implants work?
Jadelle is currently labelled for up to 5 years of continuous use
Sino-Implant (11) is labelled for up to 4 years of continuous use
Implanon is labelled for up to 3 years of continuous use

Does it hurt to have a contraceptive implant inserted and removed?  A local anaesthetic is given first and most women say it doesn’t hurt as much as they expected though removal may hurt a bit more than insertion.
Will I have a scar? Possibly a tiny one after some bruising but the implant is inserted with a hollow needle in the doctor’s clinic then bandaged, no major surgery is needed.
Will the implant be visible? NO, not unless you are VERY thin but you can feel it under the skin.

How soon am I protected? After 24 hours but remember that unless you use a condom aswell, you are NOT protected from STD’s.
Do I need a follow up visit to my doctor? NO, not unless you have any concerns.
Will an implant make me infertile? NO, fertility resumes with normal bleeding patterns after removal of the device.
Can the implant move around my body? NO. Very rarely a rod may start to come out because it was not inserted correctly or infection has occurred (in the first 4 months). Go straight to the doctor.
Do implants interrupt a current pregnancy? NO and they will not harm a fetus if you get pregnant during use.
Do contraceptive implants cause cancer? NO, studies have not shown increased risk but if you have or have had breast cancer implants are not for you.
Will an implant make me ‘moody’? Generally NO, some women complain of this side effect but the majority don’t- some even report an improvement in mood changes and sex drive.

Will a contraceptive implant change my sex drive? There is no evidence for this.
I am breastfeeding-will a contraceptive implant affect my baby? Wait for 6 weeks after the birth then an implant will be permitted and is deemed to be safe.

I am overweight - can I use a contraceptive implant? YES but you may need to have it replaced earlier than its recommended ‘life span’, depending on the brand.
I have HIV, can I use a contraceptive implant? YES but use a condom also
I have abnormal vaginal bleeding- does this mean I can’t use implants at all? NO, not necessarily but get a proper diagnosis and treatment first then ask to be re-evaluated for an implant.
I have a liver disease- can I use a contraceptive implants? NO, hormonal contraceptives are not for you.
I’m a heavy smoker and I’m over 35 years old- can I use an implant? YES. Contraceptive implants contain a progestin hormone, not estrogen which increases the risk of blood clots. However, if you suffer from serious clotting in your legs or lungs, contraceptive implants are not suitable for you.
Can I go back to work after having a contraceptive implant inserted? YES, providing you do not bump the insertion site or get it wet.
Can an implant be left in my arm permanently? It will not do you any harm but beyond its effective lifespan it will no longer be releasing its hormone and providing you with protection so this is not recommended. You will be given a reminder card with the type of implant on it and the dateby which it should beremoved.

WARNING: If you are taking ANY medications for seizures, tuberculosis or other illnesses they may reduce the effectiveness of a hormone -delivering, contraceptive implant so make sure you discuss contraceptive alternatives with your doctor.

That was a lot of information to get through but I hope you found it valuable. If you want a brief handout to take with you to the doctor’s GO HERE.

Sources: Ramchandran, D. andUpadhyay, U. D. “Implants: The Next Generation.”Population Reports, Series K, No. 7. Baltimore,INFO Project, Johns Hopkins Bloomberg School of Public Health, October 2007

‘Family Planning- a Global Handbook for Providers’.