Implanon

Implanon is a long-term progesterone-only contraceptive. It is a small, semi-rigid rod made of ethylene vinylacetate copolymer and impregnated with 68mg of etonogestrel. 

The Implanon implant is 4cm long and 2mm in diameter, and is inserted under the skin of the upper arm. Implanon works at full effectiveness for three years, after which time it should be removed and, if desired, replaced.

Implanon is very inexpensive - for an Australian woman with a Health Care Card the entire cost is $3.60, or $1.10 per year. It is also highly effective. In the trials of Implanon so far carried out, there have been no reported pregnancies at all. However, as the company itself will tell you,  "No contraception is 100% effective"

Implanon works by tricking your body into believing it is already pregnant. The ovaries do not bring new eggs to ripeness, and do not release any. Implanon also makes the lining of the uterus slightly hostile to implantation of a zygote, and thickens the mucous plug in the cervix, making it unlikely that any sperm can reach the uterus.

Before you make an appointment to have Implanon inserted, you should discuss with your doctor whether she has had training in both insertion and removal of it. She will discuss with you the best time for you to have Implanon inserted. These times vary depending on from which form of contraceptive you are switching:

• No preceding hormonal contraceptive
  • Days 1 - 5 of your menstrual cycle (where day 1 is the first day of menstruation)
• Combined Oral Contraceptive
  • On the day after the last active pill is taken
• Progesterone Only Oral Contraceptive (mini pill)
  • Any day
• Progesterone Only Injectable Contraceptive
  • On the day the next injection would be due
• Following Miscarriage or Abortion
  • Your Doctor or will discuss the options with you and together you can decide a date, dependant on your particular circumstances.
• Following a Live Birth
  • If you are not breastfeeding, between 21 and 28 days from the birth of your baby. Because testing has not yet been done, the effect of Implanon's presence in the mothers of breastfed children has not been established. 

You should also discuss with her the side effects of Implanon which can include:

• Most common side affects
  • Menstrual Irregularities.
    • Most women who use Implanon experience some sort of menstrual irregularity. About 20% of women using Implanon cease menstruation altogether, and 88% of women using Implanon have reported improvement in menstrual pain.
  • Acne
    • In clinical tests 14% of women developed acne while using Implanon. Of the women who had already had an acne problem, in 59% of them it improved while using Implanon, while in 10% the condition worsened.
      
• Less common Side Effects
  • headaches
  • migraines
  • weight gain
  • breast tenderness
    
• Rare Side Effects
  • hair loss
  • mood changes
  • libido changes
  • abdominal pain
  • menstrual pain

Additionally, the insertion and removal of the Implanon device may cause local irritation, soreness and itching.

Your doctor should explain to you that, if you suffer from any of these side effects to a degree which is unacceptable to you, if you simply change your mind or if you decide to try to become pregnant before the three years are up, the implant can be easily and quickly removed. Once the Implanon is removed your fertility will quickly begin to reestablish itself, returning fully within three months.

• Preparation.

Implanon is a prescription only medication, and is administered only by doctors who have had special training in its insertion. First, the doctor measures one hand span from the joint of the elbow and marks this place with texta or other marker. Then, getting the woman to pull against her, she marks the position of the end of the bicep. A line is drawn between these two points, giving the doctor a guide as to where the Implanon must be positioned. The skin of the inner upper arm is then numbed with a local anesthetic injection and the patient is left for five or ten minutes for this anesthetic to take effect.

• Implantation

When the skin of the inner upper arm is thoroughly numb the doctor will introduce the Implanon into its correct position. She uses a very large and frightening-looking needle which slides under the skin without pain. The doctor then aligns the needle with the mark she has drawn earlier and presses the plunger before slowly withdrawing the needle.

There will probably be a small bead of blood, but not nearly enough to look scary. 

The doctor or her assistant will then dress the wound and wrap the implantation site in a pressure bandage. This bandage is to reduce the possibility and severity of bruising.

• Afterwards

The local anesthetic will wear off in about four hours. After this time your arm will be achy and sore. You may not enjoy bending it a lot. Be sure to play up to this by asking people who love you to make you cups of tea.

By the end of 48 hours after implantation your arm should feel normal, although you may have a little bruising around the injection site. If you push gently down on the area where the Implanon was inserted, you will be able to feel it with your fingers, and to make it move gently up and down.

By a week after the implantation, you should have no visible signs of the procedure, although you will still be able to feel the implant.