Implantable Contraception

What Is It?

Implantable contraception (often called the birth control implant) is a small, flexible plastic tube containing hormones that doctors insert just under the skin of a girl's upper arm. The hormones delivered in this way can help protect against pregnancy for up to 3 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  to prevent 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 that if the egg is fertilized, it may be less likely to attach to the wall of the uterus.

How Well Does It Work?

Implantable contraception is a very effective method of birth control. Over the course of 1 year, fewer than 1 out of 100 typical couples using the implant will have an accidental pregnancy. The chance of getting pregnant will increase if a girl waits longer than 3 years to replace the tube. So it's important to keep a record of when a tube was inserted, and get a new contraceptive implant on schedule or switch to another method of birth control.

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

A birth control method's effectiveness also depends on whether it's convenient — and whether it's used 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.

Abstinence (the decision to not have sex or any intimate sexual contact) is the only method that always prevents pregnancy and sexually transmitted diseases (STDs).

Protection Against STDs

Implantable contraception does not protect against STDs. Couples having sex must always use condoms along with implantable contraception to protect against STDs.

Possible Side Effects

Young women who get contraceptive implants might notice such side effects as:

• 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, the implant is not recommended for women who have had blood clots, liver disease, unexplained vaginal bleeding, or some 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 from a doctor or other medical professional who has been trained in how to insert it. Some local health clinics also might be able to insert the implant.

A doctor may require two office visits: one to examine you and talk about the implant and one to insert the tube itself. When the implant can be inserted 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 health care professional must remove the tube after 3 years — it cannot be left in a girl's arm, even after it is no longer working. The area will be numbed, then a small cut in the arm is made and the health care professional 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 a 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 get a new implant inserted after 3 years or switch to another method of birth control.

How Much Does It Cost?

The cost of implantable contraception varies widely based on location and insurance coverage. It can range from $0 to over $1,000. There is also a charge for a doctor to remove the tube.