The Subdermal Implant ‘Nexplanon’ Patient Information

This section aims to answer your questions about the contraceptive implant. It explains the benefits, risks and alternatives, as well as what to expect when you come to the surgery.

What is the Implant?

The contraceptive Implant is a small flexible rod that is inserted just under the skin on the inside of your upper arm. You are usually offered local anaesthetic in the form oof a small injection to numb the area before the implant is inserted.

The Implant contains progesterone hormone which is released slowly into your body each day for 3 years.

The Implant prevents your ovaries from releasing any eggs so that you cannot become pregnant.

What is the Implant used for and what are the benefits?

Long term contraception

The Implant is widely used as a long term reversible contraceptive and can be left in place for up to 3 years. It is one of the best forms of contraception, with only one in 100 women getting pregnant (1%)

However, should you wish to get pregnant, fertility returns to Normal when the Implant is removed.

Are there any problems with the implant?

If you are having the implant replaced, occasionally the doctor may not be able to take out your existing implant. This can be because it is embedded deeply under the skin. If this happens, your doctor will refer you to a specialist to have this assessed further.

Are there side effects?

Side effects are more common within the first few months and generally settle after continued use.

Insertion site

These may include bleeding, bruising, infection, scarring.

Local anaesthetic

Please let your doctor know if you have any medication allergies or have had any reactions to any previous anaesthetic. Occasionally, you can experience some skin irritation and itching locally around the injection site.

Hormonal

These may include breast tenderness, headaches, acne, weight changes and symptoms similar to PMS.

Bleeding problems

Some women may experience changes to their bleeding patterns. This usually settles by 3-6 months. We encourage you persevere and speak to your GP if you find this difficult.

Am I suitable for the Implant?

There are some women for whom the implant is not suitable. This will be assessed at the time of counselling. Please inform us if you have any of the following:

• allergy to progesterone
• suspected pregnancy
• unexplained vaginal bleeding
• irregular bleeding patterns with your periods
• Breast cancer
• Liver disease
• Arterial thromboembolism (clots in the arteries)

How can I prepare for having an Implant fitted?

Timing of fitting

An implant can be put in at any time in your menstrual cycle. If fitted in the first five days of your menstrual cycle, you do not require any further contraception. If fitted at any other time, you will need additional contraception for the first seven days.

Ensuring you are not pregnant

Prior to having your IUS fitted, you will need to ensure you use adequate, reliable contraception or do not have sexual intercourse from your last period. Please inform us if there is a possibility you are  pregnant.

Medications such as anti-epileptics

Tell your nurse/doctor if you are on any medications that affect your liver such as epilepsy medications as these can reduce the effect of the implant contraception

Pain relief

You may feel pain during and after the fitting. We would suggest that you take some painkillers after the fitting if the wound is painful.

What happens during the Implant fitting?

Your appointment will last 20–30 minutes. We will check that you have understood all the information provided and you will be asked to sign a consent form.

You will be asked about allergies. In particular, please inform the healthcare professional if you are allergic to any anaesthetic or rubber.

The skin will be cleaned and then numbed with a local ‘numbing’ agent (anaesthetic).You may still feel the procedure but it should not be painful.

The implant will be fitted and a small dressing and bandage applied.

If you are having your implant replaced or removed

Your doctor will remove your old implant before fitting a new one. They will check they are able to feel the implant under your skin. The skin will be cleaned and then numbed with a local ‘numbing’ agent (anaesthetic). You may still feel the procedure, but it should not be painful.

A small cut will be made close to the tip of the implant and the rod will be removed. Once the rod is removed, you will be provided with dressings. These should stay on for approximately 24-48 hours and the wound kept clean and dry.

If you are having an implant replaced, the doctor may be able to go through the same wound as the last one. However, they will check this is safe to do so. If it is not, then a new site will be used, and the same process will be followed (as above) as if you are having a new implant fitted for the first time.

Care after your implant fitting

We advise you take the bandage off after 24 hours and the dressing underneath off after 48 hours (one day after your bandage removal). It is important you keep the wound clean and dry to avoid infection. You may develop some redness, pain or swelling and we advise you take some pain relief if this occurs. If you develop redness or swelling that is spreading up/down the arm or occurs with a fever or severe pain, then please contact the GP surgery or the urgent care team (If out of GP surgery hours).