Birth Control Implant: When It's Indicated & How It's Inserted

A birth control implant is a small silicone tube inserted into a woman's arm. it is indicated to prevent pregnancy and inhibit ovulation. It works by altering the integrity of cervical mucus, which makes it more difficult for sperm to reach the uterus and fertilize the egg.

This implant is about 4 cm in length and 2 mm in diameter and contains etonogestrel in its composition. This medicinal ingredient acts similarly to progesterone, and is continuously released in small doses into the bloodstream.

Birth control implants are sold under the commercial names Nexplanon or Implanon. It should be inserted by a gynecologist in a clinical setting, after confirming whether the patient is an appropriate candidate for one.

When it's indicated

A birth control implant is indicated in the following situations:

• Preventing of pregnancy;
• Women who forget to take daily, weekly or monthly birth control
• Contraindications for the use of estrogens;
• During breastfeeding, postpartum;
• Improving PMS symptoms.

A birth control implant should be prescribed by a gynecologist, after assessing the patient's health. The doctor will also perform a pregnancy test before inserting the implant to rule out a possible pregnancy.

It is important to emphasize that the implant does not protect you from sexually transmitted infections (STIs). Therefore, even with the implant, it is important to use a condom as necessary.

How the implant works

A birth control implant contains etonogestrel, which is a synthetic hormone that works similarly to the hormone progesterone.

Etonogestrel is continuously released into the bloodstream for a period of 3 years. It prevents ovulation and makes cervical mucus thicker, which prevents sperm from reaching the uterus.

Can you get pregnant with an implant?

A birth control implant is as effective as taking a birth control pill and women with an implant have a significantly reduced chance for pregnancy.

However, if the implant is inserted after the first 5 days of the cycle, and if the woman does not use a condom for at least 7 days after the implant is inserted, there is an increased risk of becoming pregnant. In these situations, hormone levels have not reached their optimal peak to prevent pregnancy.

It is also possible to become pregnant if the implant is left in past its expiration date. If an implant has expired and unprotected sex occurs, there is a greater chance of pregnancy.

How it's inserted

A birth control implant is inserted by the gynecologist in a clinical setting. The doctor will start by assessing the woman's general health and performing a pregnancy test to rule out a possible pregnancy.

To insert a birth control implant, the doctor will:

1. Identify a place on the inside of the non-dominant arm to insert the implant;
2. Mark the skin with a surgical pen, in the place where the implant will be inserted;
3. Clean the skin with antiseptic;
4. Inject local anesthesia;
5. Insert the implant into the subdermal tissue using the applicator;
6. Palpate the application site to check that the implant is well positioned;
7. Apply a dressing to the site, which should be kept in place for 3 to 5 days after the procedure;
8. Apply sterile gauze and a compression bandage, which can be removed 24 hours after the procedure.

The device should be placed between the 1st and 5th day of menstruation under the skin, on the upper, inner part of the non-dominant arm.

When should the implant be changed?

Normally, a birth control implant is reliable for 3 years and should be changed before the last day. After this time the woman is no longer protected against possible pregnancy.

The implant can be removed at any time through a small cut in the skin, after applying an anesthetic to the skin.

How it's removed

To remove the implant, the doctor must palpate the arm to identify the location of the implant.

Then, the doctor will mark the area of the device and disinfect the skin. Then, local anesthesia will be administered and a small cut is made to remove the implant.

After a birth control implant is removed, the doctor will close the cut, either with steri-strips or stitches.

Is it possible to get pregnant immediately after the implant is removed?

It is possible to get pregnant in the first week after the implant is removed, as hormone levels will drop. This can lead to ovulation, which facilitates pregnancy.