Implantable Contraception


What Is It?



Implantable contraception is a small, flexible plastic tube
containing hormones that doctors insert just under the skin of the upper
arm. The hormones delivered in this way can help protect against
pregnancy for several years.

One form of implantable contraception is currently available in the
United States. It is a matchstick-sized flexible tube that can be left
in place and protects against pregnancy for up to 3 years.




How Does It Work?



The implanted tube slowly releases low levels of the hormone progestinprogestin
to prevent pregnancy. It primarily works by preventing ovulation (the
release of an egg during the monthly cycle). If a girl doesn't ovulate,
she cannot become pregnant because there is no egg to be fertilized. The
progestin released by the device also thickens the mucus around the
cervix. This helps prevent sperm from entering the uterus. The progestin
also thins the lining of the uterus so if the egg is fertilized it may
be less likely to attach to the wall of the uterus.

How Well Does It Work?



Experts believe the type of implantable contraception now available
in the United States to be a very effective method of birth control.
Over the course of 1 year, fewer than 1 out of 100 typical couples using
implantable contraception will have an accidental pregnancy. The chance
of getting pregnant will increase if a girl waits longer than 3 years
to replace the tube. Because if this, it's important to keep a record of
when tubes were inserted and switch to another method of contraception
or get a new contraceptive implant.

In general, how well each type of birth control method works depends
on a lot of things. These include whether a person has any health
conditions or is taking medications or herbal supplements that might
interfere with its use. For example, certain antibiotics or an herb like
St. John's wort can interfere with the effectiveness of implantable
contraception.

How well a particular method of birth control works also depends on
whether the method chosen is convenient — and whether the person
remembers to use it correctly all the time. This means the implant must
be in a good position and working properly, and that a girl needs to
remember to have it replaced on time. The only way to be 100% sure that
you won't become pregnant or get an STD is to not have sex at all
(called abstinence).Protection Against STDs



Implantable contraception does not protect against sexually transmitted diseases (STDs). Couples having sex must always use condoms along with implantable contraception to protect against STDs.

Possible Side Effects



Many young women who get contraceptive implants will notice a change
in their periods. Other side effects that some girls have include:

• irregular or no menstrual periods
  
• heavier or lighter periods
  
• spotting between periods
  
• weight gain, headaches, acne, and breast tenderness
  
• irritation, infection, and possible scarring where the tube is inserted
  
• depression
  

Some of these side effects may improve with time.

Smoking cigarettes while using implantable contraception can increase
a girl's risk of certain side effects. This is why health professionals
advise young women who use this type of birth control not to smoke.

Who Uses It?



Young women who have a hard time remembering to take birth control
pills and who want long-term protection against pregnancy may be
interested in implantable contraception.

Not all women can — or should — use implantable contraception. In
some cases, health conditions make it less effective or more risky to
use. For example, implantable contraception is not recommended for women
who have had blood clots, liver disease, unexplained vaginal bleeding,
or certain types of cancer. Talk to your doctor if you have diabetes,
migraine headaches, depression, high cholesterol, high blood pressure,
gallbladder problems, seizures, kidney disease, or other medical
problems. Also let the doctor know if you have any allergies.

Anyone who thinks she might be pregnant should not have contraceptive implants inserted.How Do You Get It?



Implantable contraception is only available through a doctor or other
medical professional who has been trained in how to insert it. Some
local health clinics may also be able to insert implantable
contraception. A doctor may require two office visits: one to examine
you and talk about implantable contraception and one to insert the tube
itself. How soon the doctor is able to insert the implant depends on
when a girl had her last period and what type of birth control she is
currently using.

After numbing the inside of the upper arm, the doctor will use a
small needle to insert the tube just under the surface. The whole
process only takes a few minutes. After the tube is put in, a girl
shouldn't do any heavy lifting for a few days.

A medical practitioner must remove the tube after 3 years — it cannot
be left in a girl's arm, even after it is no longer working. To remove
the tube, the medical practitioner numbs the area, makes a small cut in
the arm and pulls out the tube. The tube can be removed any time after
insertion — there's no need to wait the full 3 years, but you must go to
the doctor to have it removed. To avoid an unplanned pregnancy, it's
important to keep a record of when the implant was inserted and to
either switch to another method of birth control or get a new implant
inserted after 3 years.

How Much Does It Cost?



The cost of implantable contraception varies widely based on location
and insurance coverage. It can range from several hundred dollars to
over $1,000. Although there is a charge for removal, some doctors will
remove the tube even if you cannot pay.