Implant (Sub-dermal Implant)

A contraceptive sub-dermal implant is a small, flexible rod that’s placed just under the skin of your upper inner arm. It is the fourth most popular method of contraception in the UK.

Sub-dermal implant (SDI): an overview

A sub-dermal contraceptive implant is a small, flexible rod that is placed just under the skin of your upper arm. It's about the size of a matchstick.

An implant releases the progestogen hormone, similar to the natural progesterone that's produced by the ovaries. It works for three years. Your fertility should return to normal once the implant is removed.

The implant requires a small procedure to insert and remove it. You do not need a vaginal examination for this.

You can book an appointment for contraception at axess here.

Effectiveness
99%*
Lasts for
3 years
Bleeding pattern**
Irregular
Side effects
Common

How to use it:




How to use it

A clinician will insert the implant under the skin towards the back of your upper arm.

Once the implant is in place, you don't have to think about contraception. It won't interrupt sex and you won’t see it. In the UK, Nexplanon is the main contraceptive implant currently in use. It is 4cm long – the size of a matchstick.

It can be removed at any time by a trained doctor or nurse. It only takes a few minutes to remove, using a local anaesthetic.

How does it work

The hormones released by the implant prevent pregnancy by:

  • Preventing the ovaries from releasing an egg each month (ovulation)
  • Thickening the mucus in the neck of the womb, so it is harder for sperm to penetrate the womb and reach an egg
  • Thinning the lining of the womb, so there is less chance of a fertilised egg implanting into the womb.

*99.95% effective for perfect and typical use

**Your bleeding pattern may change when you use an implant. This varies from person to person. You may have no bleeding at all, or more prolonged, infrequent, or irregular bleeding. This is not harmful but may be inconvenient.

Frequently asked questions


What are the advantages of using an implant?

The advantages of using an implant are:

  • It works for three years
  • You can use it if you are breastfeeding
  • You don't have to prepare for, or interrupt, sex
  • You don't have to remember to take a pill everyday
  • You don't need a vaginal examination
  • It may reduce heavy or painful periods after the first year
  • It is suitable for those that can't take oestrogen
  • Your fertility returns to normal when it is removed
  • It may also give some protection against cancer of the womb
Are there any side effects to using an implant?

There are some common and rare side effects to using an implant.

Common short-term side effects include:

  • Spotty skin
  • Breast tenderness
  • Nausea
  • Headaches
  • Loss of sex drive
  • Changes in mood

Common long-term side effects include:

  • Bleeding pattern may change significantly. Bleeding may be prolonged or infrequent, or you may have no bleeding
    • If you have bleeding that's a problem for you at any time, talk to your healthcare professional
    • They may be able to give you some additional hormones or medicine that can help to control this
    • They may also check that the bleeding isn't due to other causes, such as infection.

Rare short-term side effects include:

  • The area of skin where the implant has been fitted can become infected. Antibiotics may be necessary if this occurs
Where can I get an implant?

You can get an implant inserted at your local axess clinic. Find your nearest clinic and contact details here.

A clinician will insert the implant under the skin, in your upper inner arm.

It can be removed at any time by a trained doctor or nurse using a simple procedure. It only takes a few minutes to remove, using a local anaesthetic.

How quickly will the implant start 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.

Can anything make the implant less effective?

The implant is the most effective method of contraception. It is more than 99.95% effective for perfect and typical use. Less than one in 1000 implant users will get pregnant in the first year of use.

Some medicines, however, may make an implant less effective. These include some of the medicines used to treat HIV, epilepsy, and tuberculosis (TB). This may also include the herbal medicine St. John's Wort.

These are called enzyme-inducing drugs. If you take these medicines, it’ll be recommended that you use additional contraception, such as condoms, or that you change to a different method of contraception. Always tell your healthcare professional that you’re using an implant if you’re prescribed any medicines.

The implant is not affected by antibiotics, diarrhoea, or vomiting. It is important to have your implant changed at the right time. If it isn't, you won't be protected from pregnancy.

Am I suitable for the implant?

You may not be able to use the implant if you have, or have had, any of the following:

  • Severe heart disease
  • Migraines
  • Breast cancer
  • Disease or tumours in the liver
  • Unexplained vaginal bleeding
  • Systemic lupus erythematosus

The implant can be fitted after having a baby. It can be fitted any time after the birth. If it is fitted on, or before, day 21 of your cycle, you'll be protected from pregnancy immediately. If the implant is inserted later than day 21, you'll need to avoid sex or use additional contraception, such as condoms, for 7 days. An implant can be used safely while you are breastfeeding and will not affect your milk supply.

The implant can be fitted immediately after having an abortion or miscarriage. If it is inserted on, or before, day 5 of your cycle, you'll be protected from pregnancy immediately. If the implant is inserted later than day 5, you'll need to avoid sex, or use additional contraception, such as condoms, for 7 days.

You can use the implant if you're approaching menopause. You can continue to use the implant until you no longer require contraception. You must continue to have the implant replaced every three years.

Does it hurt to get the implant fitted?

A local anaesthetic is used to numb the area of insertion so it won't hurt. Your doctor will make sure the area is fully numb before starting the procedure.

The small wound made in your arm is closed with a dressing and does not need stitches. There may be some bruising, tenderness, and swelling for a couple of days after the procedure.

Does the implant protect me from sexually transmitted infections (STIs)?

Most methods of contraception do not protect you from sexually transmitted infections (STIs). This includes the implant.

External and internal condoms can help to protect against STIs.

Can I have an implant fitted after an abortion or miscarriage?

The implant can be inserted immediately after a miscarriage or abortion.

If it’s inserted on, or before, day 5 you’ll be protected from pregnancy immediately. If the implant is inserted later than day five, you’ll need to avoid sex or use additional contraception, such as condoms, for seven days.