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| Basic Information |
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| Description |
- The goal of contraception (or birth control) is to prevent an
unplanned pregnancy. The majority of methods of contraception enable
sexually active couples to temporarily avoid pregnancy. Permanent
birth control is accomplished through sterilization. Be sure you
know and understand the different types of birth control available
to you, the risks and benefits of each, and any side effects, so
that you can make an informed choice.
- Hormone implants consist of six small capsules (the size of matchsticks)
containing a progestin hormone. They are inserted surgically just
under the skin of the upper arm. The implants provide birth control
for five years by slowly releasing the hormones in the capsules
into the body. Hormones work by blocking ovulation and by thickening
the cervical mucus to make sperm penetration more difficult and
also change the endometrium lining of the uterus to make it unsuitable
for implantation of a fertile egg.
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| Advantages |
- Are very effective for contraceptive use (over 99%); one of the
most effective temporary forms of birth control available.
- The hormone used in the implants, progestin, provides a birth
control option for women who cannot take estrogen hormones that
are used in oral contraceptives.
- The implants require no daily routine.
- Enjoyment of spontaneous sexual intercourse; freedom from concern
once implants are in place.
- Although they cannot be discontinued as easily as discontinuing
a daily pill (oral contraceptives), they can be removed at any time
by a trained health care provider.
- They are effective for up to 5 years. There is no significant
delay in restoration of fertility following removal.
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| Disadvantages |
- They require a minor surgical procedure with a local anesthetic
for insertion. Some minor skin side effects may occur at the implantation
site.
- Some women experience problems when the implants are removed
including a longer surgical time, pain and scarring.
- Side effects from the implants include menstrual irregularities,
headaches, depression and weight gain. The side effects tend to
diminish with time.
- They should not be used in women who have a blood clotting disorder,
heart problems, undiagnosed vaginal bleeding, liver problems or
breast cancer.
- Up front costs are high since there is a one time payment, but
the overall costs for a 5 year period are comparable to oral contraceptives.
- They will not protect against sexually transmitted diseases (STDs).
A form of barrier protection will need to be used.
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| Treatment/Post Procedure Care |
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| General Measures |
- The implants are usually inserted during the first seven days
of a woman's menstrual cycle (ensuring she is not pregnant). However,
they can be inserted anytime if pregnancy has been ruled out. Another
form of birth control (nonhormonal) should be used for the remainder
of the cycle.
- A patient information booklet will be provided for you to read
prior to the implants being inserted. Be sure any questions or concerns
you have are answered or explained.
- 1) To insert:
- The procedure will be done in a health care provider's office
(doctor, nurse-practitioner, or family planning clinic). It should
take about 15 minutes.
- A local anesthetic is injected into the upper arm (may cause some
stinging).
- A small incision is made and one by one, the six capsules are
placed under the skin in a fan shape position.
- A protective bandage is placed over the incision which can be
removed in a few days.
- There may be some discoloration, bruising or swelling in the incision
area for a few days.
- 2) To remove:
- Again, the procedure will be done in a health care provider's
office and should take less than 30 minutes.
- The capsules are located by being palpated (felt); a local anesthetic
is injected.
- An incision is made and the capsules are withdrawn, one by one.
If the capsules cannot all be removed on the first attempt, removal
should be attempted later after the site has healed.
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| Medication |
- Carbamazepine and phenytoin reduce the effectiveness of the hormone
implants and may increase the risk of pregnancy.
- Advise anyone who prescribes a medicine for you or before any
anesthetic is used that you have the hormone implants.
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| Notify Your Healthcare Provider If |
- You are interested in hormone implants for contraception.
- After implantation, unexpected side effects occur, such as severe
abdominal pain.
- Heavy vaginal bleeding develops.
- You have had the hormone implants for about five years and they
need to be replaced.
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