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Implanon - The Contraceptive Implant

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Updated April 05, 2014

Implanon - The Contraceptive Implant

Implanon

Photo Courtesy of Organon USA Inc.

Definition of Implanon:

Implanon is a type of birth control implant, receiving FDA-approval in July 2006. This contraceptive implant is a thin rod, 40 mm in length and 2 mm in diameter -- about the size of a cardboard matchstick. It's made from a flexible plastic and is inserted just under the skin on the inner side of your upper arm. Implanon is a progestin-only method and provides about 3 years of pregnancy protection. Insertion requires a local anesthetic and only takes a few minutes. The implant can also be removed anytime before the 3 years are up. Implanon does not contain latex or silicone and will not dissolve, so it must be removed.

As of November 2011, the FDA has approved the use of Nexplanon in the US, a newer version of Implanon. Other than a few minor changes, such that Nexplanon is radiopaque and has a slightly different applicator/insertion procedure, Nexplanon is almost identical to Implanon.

How Implanon Works:

Implanon continually releases a low dose of etonogestrel (a progestin) to protect against pregnancy for up to 3 years. It contains 68 milligrams of etonogestrel, released over the 3-year period; about 60 to 70 micrograms per day are released in the first year, and the amount decreases over time. After the third year, Implanon will still release some hormone, but it will not be enough to prevent pregnancy.

Implanon Advantages:

  • It is a safe and highly effective birth control method

  • A good alternative option for women who can't use estrogen-based contraceptives

  • Provides continuous pregnancy prevention for 3 years and can be removed anytime within the 3-year period

  • After removal, a woman’s ability to become pregnant returns quickly; some women have reported becoming pregnant within days after removal of the contraceptive implant

  • It is a private and discreet birth control method. Nobody can tell if you are using it, and there is no packaging or other evidence of use that may embarrass some women

  • Most women can’t see Implanon after its insertion
  • It allows for continuous, long-lasting birth control without the need of a tubal ligation

  • Convenient and hassle-free –- once inserted, you don’t have to do anything

  • It can be used while breastfeeding

  • Implanon can improve a woman's sex life by allowing for spontaneity (nothing needs to be inserted or put on prior to sexual intercourse)

  • If Implanon is inserted as recommended by the manufacturer (such between the first and fifth day of one’s period), a backup birth control method is not necessary

  • Due to the low and steady hormone delivery, Implanon has fewer hormonal ups and downs than daily or weekly birth control methods

Implanon Disadvantages:

Irregular bleeding is the most common side effect for women using Implanon. Organon, the manufacturer of Implanon, advises that you should expect your periods to be irregular and unpredictable throughout the time you are using the birth control implant. For many women, periods become fewer and lighter, and in time, they may stop altogether. Other women report having longer and heavier periods while others experience an increase in spotting and breakthrough bleeding (between periods). In studies, about 1 out of 10 women stopped using Implanon because of bleeding changes.

About 1 out of 3 contraceptive implant users have no periods after one year.

Implant site complications were experienced by 3.6% of clinical study participants. Pain was the most frequent implant site complication, reported during and/or after insertion, occurring in 2.9% of subjects. Additionally, hematoma, redness, and swelling were reported by 0.1% to 0.3% of women.

Removal complications occurred in 1.7% of participants and included: implant couldn’t be felt, broken or damaged implant, difficult localization, and slight movement.

There is a slight risk that you will get a scar from insertion or removal of Implanon.

Implanon Side Effects:

Besides irregular bleeding, the most frequent side effects causing women to stop using Implanon include mood swings, weight gain, breast tenderness, headache, acne, and depression.

Additional side effects reported by women using Implanon are:

  • Dizziness
  • Vaginitis
  • Stomach pain
  • Hair loss
  • Painful periods
  • Nervousness
  • Back pain
  • Nausea
  • Pain at insertion site
  • Viral infections (colds, sore throats, sinus infections, or flu-like symptoms)

    Rare side effects that have also been reported include: extra hair on the face and body, trouble using contact lenses, and spotty darkening of the skin, especially on the face.

  • Possible Complications of Implanon:

    Serious problems with Implanon are rare, yet it is critical to report any complications to your doctor right away.
    • Complications of Insertion: Rarely, Implanon is not inserted because the implant has fallen out of the needle. Thus, after insertion, you should be able to feel the implant under your skin. If you cannot feel it, tell your doctor immediately.

    • Complications of Removal: Removal of Implanon could potentially be difficult or impossible due to the implant not being where it should. If Implanon cannot be removed, then its effects will continue for a longer period of time.
    • Ectopic Pregnancy: If you happen to become pregnant while on Implanon, there is a slightly higher chance (as compared to women who are not using birth control) that the pregnancy will be ectopic.

    • Medication Interaction: Certain medicines may make Implanon less effective (like ones that induce liver enzymes), so you may need to use a back-up contraceptive method. Make sure to tell your doctor about any medicines you are taking or plan to use.

    Who Can Use Implanon: This is a safe birth control option for most healthy women. It is important to discuss your full medical history with your doctor before using the implant.

    Some women could still use Implanon even with certain risk factors as long as they remain under close medical supervision. But Implanon may not be the right method for everyone. Implanon use is not recommended if you:

    • Are pregnant or think you may be pregnant
    • Have or have had breast cancer
    • Have unexplained vaginal bleeding
    • Have liver disease
    • Have a history of severe depression
    • Have or had serious blood clots: in your legs (deep venous thrombosis), lungs (pulmonary embolism), eyes (retinal thrombosis), heart (heart attack), or head (stroke)
    Additionally, discuss with your doctor about the use of Implanon if you have or had diabetes, high cholesterol or triglycerides, headaches, seizures/epilepsy, gallbladder or kidney disease, high blood pressure, or an allergic reaction to anesthetics or antiseptics.

    How to Obtain: The use of Implanon requires a medical prescription. Plan for two doctor's visits: first, you will need to have a medical evaluation which includes a blood pressure check and possibly a pelvic exam. At this time, your doctor should discuss the advantages and disadvantages of Implanon and will make an appointment for you to return for the insertion of the implant.

    Implanon Costs: Given the newness of this method, prices vary from area to area. The cost also depends on insurance, copays, and the facility. In general, it appears that the total cost (for the Implanon device, medical visits, and insertion fees) can range from $500 to $750 (which averages under $20 a month over the 3 years). The one-time cost of Implanon, as compared to other contraceptive methods, could save you much more money over time.

    Effectiveness: Implanon is 99.9% effective. This means that out of every 100 women who use Implanon in one year, less than 1 will become pregnant with typical use as well as with perfect use.

    Implanon may be less effective in women who are overweight as the progestin serum levels are inversely related to body weight.

    The effectiveness of Implanon decreases if it has been in place for more than 3 years.

    STD Protection: Implanon offers no protection against sexually transmitted infections.

    Find a Qualified Implanon Doctor: Given that Implanon has been phased out -- being replaced by its newer version, Nexplanon, it may be difficult to find a doctor who still has Implanon stock. Nexplanon allows for more accuracy during the insertion process and, like Implanon, must be inserted and removed by a trained health care provider. Trained health care providers have completed a Merck clinical training program on Nexplanon.

    Source:

    Organon. IMPLANON (etonogestrel implant): Prescribing Information. http://www.spfiles.com/piimplanon.pd.pdf. Accessed July 8, 2009.

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