Contraception guide

Contraceptive implant

A woman can get pregnant if a man’s sperm reaches one of her eggs (ova). Contraception tries to stop this happening by keeping the egg and sperm apart or by stopping egg production. One method is the implant.

The contraceptive implant is a small flexible tube about 40mm long that's inserted under the skin of your upper arm. It's inserted by a trained professional, such as a doctor, and lasts for three years. 

The implant stops the release of an egg from the ovary by slowly releasing progestogen into your body. Progestogen thickens the cervical mucus and thins the womb lining. This makes it harder for sperm to move through your cervix, and less likely for your womb to accept a fertilised egg.

At a glance: the implant

  • If implanted correctly, it's more than 99% effective. Fewer than one woman in 1,000 who use the implant as contraception will get pregnant in one year.
  • It's very useful for women who know they don't want to get pregnant for a while. Once the implant is in place, you don't have to think about contraception for three years. 
  • It can be useful for women who can't use contraception that contains oestrogen. 
  • It's very useful for women who find it difficult to take a pill at the same time every day. 
  • If you have side effects, the implant can be taken out. You can have the implant removed at any time, and your natural fertility will return very quickly.
  • When it's first put in, you may feel some bruising, tenderness or swelling around the implant. 
  • In the first year after the implant is fitted, your periods may become irregular, lighter, heavier or longer. This usually settles down after the first year. 
  • A common side effect of the implant is that your periods stop (amenorrhoea). It's not harmful, but you may want to consider this before deciding to have an implant. 
  • Some medications can make the implant less effective, and additional contraceptive precautions need to be followed when you are taking these medications (see Will other medicines affect the implant?).
  • The implant does not protect against sexually transmitted infections (STIs). By using condoms as well as the implant, you'll help to protect yourself against STIs.

How the implant works

The implant steadily releases the hormone progestogen into your bloodstream. Progestogen is similar to the natural hormone progesterone, which is released by a woman's ovaries during her period.

The continuous release of progestogen:

  • stops a woman releasing an egg every month (ovulation) 
  • thickens the mucus from the cervix (entrance to the womb), making it difficult for sperm to pass through to the womb and reach an unfertilised egg
  • makes the lining of the womb thinner so that it is unable to support a fertilised egg

You can get contraception at:

  • most GP surgeries
  • community contraception clinics
  • some GUM clinics
  • sexual health clinics
  • some young people's services

Find a clinic near you

The implant can be put in at any time during your menstrual cycle, as long as you and your doctor are reasonably sure you are not pregnant. In the UK, Nexplanon is the main contraceptive implant currently in use. Implants inserted before October 2010 were called Implanon. Since October 2010 insertion of Implanon has decreased as stocks are used up, and Nexplanon has become the most commonly used implant.

Both types of implant work in the same way, but Nexplanon is designed to reduce the risk of insertion errors and is visible on an X-ray or CT (computerised tomography) scan. There is no need for existing Implanon users to have their implant removed and replaced by Nexplanon ahead of its usual replacement time.

Nexplanon is a small, thin, flexible tube about 4cm long. It is implanted under the skin of your upper arm by a doctor or nurse. A local anaesthetic is used to numb the area. The small wound made in your arm is closed with a dressing and does not need stitches.

Nexplanon works for up to three years before it needs to be replaced. You can continue to use it until you reach the menopause, when a woman’s monthly periods stop at around 52 years of age. The implant can be removed at any time by a specially trained doctor or nurse. It only takes a few minutes to remove, using a local anaesthetic.

As soon as the implant has been removed, you will no longer be protected against pregnancy.

When it starts to work

If the implant is fitted during the first five days of your menstrual cycle, you will be immediately protected against becoming pregnant. If it is fitted on any other day of your menstrual cycle, you will not be protected against pregnancy for up to seven days, and should use another method, such as condoms.  

After giving birth

You can have the contraceptive implant fitted after you have given birth, usually after three weeks.

  • If it is fitted on or before day 21 after the birth, you will be immediately protected against becoming pregnant. 
  • If it is fitted after day 21, you will need to use additional contraception, such as condoms, for the following seven days.

It is safe to use the implant while you are breastfeeding.

After a miscarriage or abortion

The implant can be fitted immediately after a miscarriage or an abortion, and you will be protected against pregnancy straight away.

Who can use the implant

Most women can be fitted with the contraceptive implant. It may not be suitable if you:

Advantages and disadvantages of the implant

The main advantages of the contraceptive implant are:

  • it works for three years
  • the implant does not interrupt sex
  • it is an option if you cannot use oestrogen-based contraception, such as the combined contraceptive pill, contraceptive patch or vaginal ring
  • you do not have to remember to take a pill every day
  • the implant is safe to use while you are breastfeeding
  • your fertility should return to normal as soon as the implant is removed
  • implants offer some protection against pelvic inflammatory disease (the mucus from the cervix may stop bacteria entering the womb) and may also give some protection against cancer of the womb
  • the implant may reduce heavy periods or painful periods after the first year of use
  • after the contraceptive implant has been inserted, you should be able to carry out normal activities

Using a contraceptive implant may have some disadvantages, which you should consider carefully before deciding on the right method of contraception for you. These include:

Disrupted periods

Your periods may change significantly while using a contraceptive implant. Around 20% of women using the implant will have no bleeding, and almost 50% will have infrequent or prolonged bleeding. Bleeding patterns are likely to remain irregular, although they may settle down after the first year.

Although these changes are not harmful, they may not be acceptable for some women. Your GP may be able to help by providing additional medication if you have prolonged bleeding.

Other side effects that some women report are:

  • headaches
  • acne
  • nausea
  • breast tenderness
  • changes in mood
  • loss of sex drive

These side effects usually stop after the first few months. If you have prolonged or severe headaches or other side effects, tell your doctor.

Some women put on weight while using the implant, but there is no evidence to show that the implant causes weight gain.

Will other medicines affect the implant?

Some medicines can reduce the implant's effectiveness. These include:

  • medication for HIV
  • medication for epilepsy
  • complementary remedies, such as St John's Wort
  • an antibiotic called rifabutin (which can be used to treat tuberculosis)
  • an antibiotic called rifampicin (which can be used to treat several conditions, including tuberculosis and meningitis)

These are called enzyme inducing drugs. If you are using these medicines for a short while (for example, rifampicin to protect against meningitis), it is recommended that you use additional contraception during the course of treatment and for 28 days afterwards. The additional contraception could be condoms, or a single dose of the contraceptive injection. The implant can remain in place if you have the injection.

Women taking enzyme inducing drugs in the long term may wish to consider using a method of contraception that isn't affected by their medication.

Always tell your doctor that you are using an implant if you are prescribed any medicines. Ask your doctor or nurse for more details about the implant and other medication.

Risks of the implant

In rare cases, the area of skin where the implant has been fitted can become infected. If this happens, the area will be cleaned and may be treated with antibiotics.

Where you can get the contraceptive implant

Most types of contraception are available free in the UK. Contraception is free to all women and men through the NHS. Places where you can get contraception include:

  • most GP surgeries – talk to your GP or practice nurse
  • community contraception clinics
  • some genitourinary medicine (GUM) clinics
  • sexual health clinics – they also offer contraceptive and STI testing services
  • some young people’s services (call 0300 123 7123 for more information)

Find your nearest sexual health clinic by searching by postcode or town.

Contraception services are free and confidential, including for people under the age of 16.

If you're under 16 and want contraception, the doctor, nurse or pharmacist won't tell your parents (or carer) as long as they believe you fully understand the information you're given, and your decisions. Doctors and nurses work under strict guidelines when dealing with people under 16. They'll encourage you to consider telling your parents, but they won't make you. The only time that a professional might want to tell someone else is if they believe you're at risk of harm, such as abuse. The risk would need to be serious, and they would usually discuss this with you first.

Page last reviewed: 10/01/2013

Next review due: 10/01/2015

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Comments

The 26 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Zara1991 said on 15 April 2014

I had my first implant fitted around 2 years ago and the first year and half it was great I first had no periods apart for a little bit of bleeding every couple of months for about 3 days. But then I started getting heavier painful periods again just like before I had it fitted. I was given the pill to take along side it to help but sadly it didn't work and in the end I was continuously bleeding for four months until the doctor agreed to replace it. I had it taken out about 2 weeks ago now and again my period stopped until this Monday and it's started again and this time it's really painful and it seems the implant has moved. I don't know what to do I have an operation coming up and I am a bit scared because I don't want it to be postponed because of the amount of blood I have lost over the months.

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sundak2009 said on 15 April 2014

I recently did the implant around Oct 2013. I have undergone certain changes such as not seeing my periods. But my greatest worry is that I am adding weight and I am not a fat person. Before the implant I was weighing 65kg but now i weigh 71kg under 6months. I am adding weight in my face and my hips and buttocks. I met my doctor who said it it is the implant and would want to watch and see after 6months. I am worried by then it will be impossible to reduce my weight. I like the implant but weight gain is making me reconsider removing it. Please I need help.

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meryl22 said on 01 April 2014

I had the Nexplanon implant and had no issues with it at all. I had previously suffered severe pains when I was on the pill. This allowed me to be normal and pain free. However I have had it removed as it's 3 years were up and do not require anything else as my partner and I are considering trying for a baby. I have been looking on sites to see what the standard time is for periods to return to normal but haven't found anything. For 5 weeks now I have had all the pains and aches return and I have to say it's not a pleasant time, but still no period. Not had the implant before so got nothing to measure it against. The pain is that bad I'm considering having another implant put back :( I think that there is need for the aftermath of an implant is required on sites too. Definitely recommend Nexplanon.

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GTC1993 said on 26 March 2014

I had the implant fitted in 2010. It was great for me and I didn't suffer any side affects except from a very slight fase of acne which tablets help! However in October 2013 I got my implant taken out and the new nexplanon refitted! Welllllll.... Since then every time I am "due on" I get awful cramps and nausea which has led to vomiting every time. Before this I never suffered with illness like I do now. The nexplanon is extremely strong!!!

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cillarose760 said on 23 March 2014

Ive had the implanon for about two weeks now, and ive been experiencing sharp pains all down my arm. from my armpit to my fingers. I don't know if I should contact my doctor or see if it goes away. The thing is it is keeping me from sleeping and is very bothersome, I can tell its from the implant cause that general area hurts too. Im waiting to see if it goes away but so far its not a very good experience.

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NewGirl95 said on 20 March 2014

ad the implant fitted when I was 14, just before they stopped using implanon. I has no issues at all, 3 years with little to no bleeding no side affects or anything... In March last year I went to have my implant removed and refitted. Obviously I had Nexplanon fitted, not a pleasant experience. I would point out ythat if you are having problems then go back and tell them. Even if they do say it could be a short term thing if you ask them to remove it they do not have a choice but to make an appointment to do so. I was diagnosed with depression after having it removed only because my doctor wasn't happy to say it wasn't to do with the new implant.
When I had this removed I was told by my family planning nurse that in the EU it was under black triangle and she would be putting a yellow card in about it. If a high enough percentage of people have Nexplanon and develop depression and nurses/doctors are following procedure then it will be added as potential side effect.
People seem to forget depression can develop at any time for virtually any reason, my doctor just wasn't happy to actually diagnose depression and give me medication without ruling that out the possibility that it could be the implant...

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Cerian86 said on 15 March 2014

Can the implanon do any damage to my body?? Or stop me from having any children? I have had 2 implanon and I'm on my third one, I'm starting to think that I won't be able to have any children xx

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pippa05 said on 12 March 2014

I have to say that I have the implant (for the second time) and I guess I am lucky because I haven't suffered with any side affects that some people have mentioned. My periods are extremely light and are about every 3 weeks which last about a week. This is a nuisance but it is a huge improvement on my periods before the implant was fitted. I do have the dark blood that some people have mentioned but I can't say that it bothers me. I was bleeding practically non stop beforehand and very heavily so I personally would recommend the implant to people but then i did my research before I had it fitted and the nurse who fitted it was very helpful in answering any questions I had.

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chloe_a said on 09 March 2014

I'm just here to share my experience with the implant so far

Before I got, my periods were fine, got them regularly about every 6 weeks.

I got the implant inserted at the start of December 2013 - all was fine, my period came as normal at the end of Decmber

However, since then I haven't stopped bleeding

I don't want to gross people out with the details but it's not been fresh red blood, it's a darker browner blood but still a significant amount that comes out everyday, not just "spotting" - but every 2 weeks or so it's fresh blood instead

So yeah, I've been bleeding for nearly 3 months straight now - it's a pain, but I'm just gonna hang in here and hope that it ends soon as the doctor said before she inserted that after 6 months everything should have calmed down and I shouldn't get my period anymore

Fingers crossed

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KerrytheBerry said on 07 March 2014

I was fitted with the implant in 2009 as I was allergic to the combined pill. I was advised by my GP that the implant was the best thing since sliced bread & my periods would stop, I would not get pregnant etc etc. However I had loads of problems, and I was silly enough to get fitted with another one in 2012 and wish I had listened to my instinct & not bothered. Since having the implant I am on a constant period, but its not red blood, its a brown horrible colour and its embarrasing, I cant wear nice knickers, I cant wear tampons because its too light but if I wear a pad it makes me really sore (due to the rubbing). I have really really bad scarring acne that has affected me dramatically and have to have microdermabrasion to try and combat this, it makes me feel uneasy to be round my friends who have lovely skin)I used to have nice skin- yeah the odd spot here and there but now I have scars. I have terrible pmt, 1 minute I'm crying with laughter, the next I feel like taring my hair out! and as for sex, me & my fiance have been together for 6+ years and I have no sex drive what so ever, which makes us both feel at a loss! I wouldnt personally reccommend the implant. However if you do want it, make sure you research it and make a firm decision as it is in your body for 3 years. Hope this helps!

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jax36 said on 06 March 2014

IDue to quite severe pmt I decided after 11 years(10 years with merina coil and 1 with nexplanon) to have the implant removed so that I could find out if my pmt is better or worse without these forms of contraceptives, it has been 2 weeks now and in honesty I feel terrible, I was not prepared for this, I could give a whole list of symptoms but there's no point, I just feel that there isn't any information given to us about we might go through after especially to those of us who have used ius/implants for a long time.

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jlm1407 said on 25 February 2014

I am extremely annoyed at G.P,'s fitting this implant to teenage girls without any follow up. My daughter was fitted with the implant but started with mood swings shortly after. Although she went to see her GP he informed her that this was one of the side effects but should level out within three months. This has not happened ! In fact the mood swings which were happening around twice then three times a week, started to increase daily - now the mood swings are hourly - constant throughout each day! This drug is ruining her life, it is ruining her ability to socialise, it is ruining her relationship with her me, her mother, and her boyfriend. I have now contacted her surgery 3 times and have made it very clear what is happening but the GP's do not care. They have been negligent, even to the point that I have told them that if she does anything stupid they are responsible....still they have not bothered. What I fail to understand is that if the implant works by increasing the level of progestogen, surely a hormone level test should be carried out and if the levels need altering - why can this not be carried out? This situation is causing so much depression for my daughter and her loved ones - at my wits end

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Mamalou2007 said on 19 February 2014

I had my implant replaced on 12 dec 2013, came on 2 weeks later and now I haven't had a period since the end on dec, this is a bit worrying as the first time I had the implant I was always seening my periods every months. But now almost 3 weeks late since I was last due, plus I have been feeling sick most morning and getting cramping pains on and off. I have done pregnancy test and it's saying not pregnant. But still concerned as I never had this with my first implant. Is this right to happen?

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Mummykelly said on 17 February 2014

Hi I had the nexplanon implant put in on 5 of November 2013 I was having a miscarriage at the time so was still bleeding for another week or so and I haven bleed sins I've put on quite a bit of wight lately and feel sick and tired all the time just wondering if anyone as any advise as to what it could be I have done pregnancy test and nothing !

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OrangeLeopard said on 06 February 2014

Having the iplant varies for many people. I personally have one and would recommend it to friends and family. I have had 2 years of no periods, am on my last year and i have only had a slight bleed. The NHS does need to make people aware of the fact that the implant doesnt necessarily protect you against pregnancy for the full 3 years if you are overwight or have a high BMI. It is recommended that you have the implant renewed before you 3 year time.

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Lina03 said on 30 January 2014

I have had the implant since early April 2013. My period stopped up until July when it started bleeding constantly; that wasn't a big problem for me as it was very light. As I was going on holiday abroad during August my GP suggested I go on the pill to stop the bleeding. The pill worked however, When I got back to England I decided to stop taking the pill. My period stopped when I stopped taking the pill but came back as normal every month and went up until January. My period has been constantly bleeding again but very heavily and it hasn't stopped since it came. I have also experienced very bad cramps which wasn't the case before taking any contraception. I have decided to wait till April to decide whether I want to stay on the implant or remove it.

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panda_monium said on 30 January 2014

I've been using the contraceptive implant for almost six years now. I'm on my second implant and due to have it replaced with my third in the next few months. I absolutely love it! My periods are light and brief, and usually only every second month. I've had no emotional or physical side effects and I recommend it to all of my friends!

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Laurenyates95 said on 29 January 2014

I had the implant when I was 16 years old, I had beautiful skin and was always happy. A year on with the implant I started to notice acne break outs, this was happening for two years, and my friends and family noticed I wasn't as happy anymore. I was happy that my periods stopped and I didn't have to worry about one until the last year of my implant I was on for 6 weeks straight. I wouldn't recommend this to anyone really, it's ruined my life.

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HannahJayy1207 said on 23 January 2014

I had the implant put in on 20/11/13 and it was excellent until christmas, now i am bleeding constantly with bad cramps, all though my periods are light i am in a lot of pain, as with the drinking i have been fine so far, i can remember nights out and that :)

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xaluar said on 11 January 2014

Everyone I know always slates the implant and for that reason I was reluctant to try it. But my advice to anyone reading this is it is definitely worth it. I started on the combined pill but had to switch to the progesterone only pill due to migraines. The POP was a nightmare it made me miserable, have no sex drive and I also got fat. I was reluctant to try the implant as I said as 1. it also uses progesterone (all be it a smaller dose) and 2. I had heard from most people that you bleed continuously. I got the implant in September and it was the best decision I made. I have lost weight, sex drive is back to normal and my periods have been non existent (though I was not worried, as the implant is the MOST effective method of contraception). This month i got my first (very light) period since being on the implant and have been told they will gradually return as I continue to use it, which is even better. I have had no pain, no acne, no anxiety/depression or anything. Would definitely recommend especially to those who are having problems with contraceptive pills.

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Boomchicka said on 16 December 2013

I've had the implant for nearly two years and I love it! Having suffered horrible cramps during my periods I no longer have to spend days in horrendous pain! My acne has got a little better, but certainly no worse! I have a very light period every three or four months and don't have to worry about taking the pill everyday , superb!!!!!

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chloe_aw said on 15 December 2013

@unigirl93 - I have had a really similar experience with the implant to you. I forget nights after a few drinks and I've either had a huge fight with my boyfriend or I've cried my eyes out apparently. I've also experienced depression, which I did not relate to the implant until reading your comment. Now I'm worried! The NHS should be doing more to recognise what it can really do to people!

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unigirl93 said on 12 December 2013

I personally had a horrible experience with the implant, sending me into a deep depression as well as putting in me in a lot of danger. Every time I had more than two drinks, I would have no memory of the night the next morning, but I would be informed that I would fly into a rage or sob for hours for absolutely no reason. This caused huge problems with friends and in my relationship.
I feel that the NHS needs to better monitor those who get the implant, and it should certainly be noted on this page that the implant can lead to depression or anxiety.

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bwillott said on 03 December 2013

I had the implant in 2012 and been fine right up till now 2013 mood swings... bleeding for 3 weeks at a time... headaches everyother day... I loved it at 1st but its coming out next week

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maybe123 said on 05 November 2013

Should be able to feel it in her inner arm. Or look for a little scare where it had been removed.

If you cant feel it than the inplant are not there! I had it remove and it left me with a little scare.

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feelingsick said on 04 November 2013

hey can someone help me. I had sex with a girl who had this implant in it had no marks to say she just had it put in. Could she have took the out and got pregnant cause now she telling me she is

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Contraceptive injection

It lasts for eight to 12 weeks (depending on the type) and you can forget about it until it needs renewing

Emergency contraception

Emergency contraception (the pill or IUD) can be used to prevent pregnancy after unprotected sex

Where to get contraception

Find out where you can go to get information about contraception, and to get the method you choose

Sexual health services

Find out where you can go if you need advice about STIs, contraception or pregnancy