Birth control implants - All your doubts answered
McKinnon Hill Medical Center

Sub dermal implants - All your doubts answered

In this article, we will answer all your questions and doubts regarding the new method of contraception called implants, also known as sub dermal or subcutaneous implants. So let’s get started.

What is an implant? 

The implant, is a long-term birth control method used for contraception. It is a small almost plastic rod that is inserted under the skin below the upper arm by a doctor or gynaecologist. That is why they are also known as sub-dermal implants or subcutaneous implants. 

This rod releases hormones that help prevent ovulation and thicken the cervical mucus inside the uterus, which blocks the path for sperm to reach the egg.

The chances of pregnancy are significantly reduced with this method. After insertion, you receive contraceptive protection for approximately 3 to 5 years ( depending on the brand), and there is no need to regularly take pills or worry about other methods.

How is the sub-dermal implant inserted? 

The procedure for implant insertion and removal generally takes about 5-10 minutes, and it does not require surgery. 

The procedure is done in a doctor’s clinic where he will numb your arm first and then insert the rod beneath the skin below the upper arm. Local anaesthesia is administered during this process to ensure that you do not experience any pain or discomfort.

After the implant is inserted or removed, you may experience slight pain or swelling, but this is temporary and typically resolves quickly.

How does a subcutaneous implant work? 

The implant contains the hormone progestin. Progestin is a synthetic version of the hormone progesterone, which is naturally produced in the female body.

Through the implant, progestin hormones are released, which thickens the cervical mucus inside the uterus and prevents sperm from reaching the egg. Additionally, progestin helps in inhibiting ovulation (egg release), reducing the chances of pregnancy.

Progestin-only birth control methods, such as implants, mini-pills, and hormonal intrauterine devices (IUDs), work without the presence of estrogen hormone. Therefore, progestin-based methods help avoid estrogen-related side effects (such as weight gain, nausea etc.) 

Can breastfeeding mothers use sub-dermal implants? 

Birth control implants containing the progestin hormone are generally safe for breastfeeding women. Progestin-only methods, such as implants, mini-pills, and hormonal IUDs, work without the presence of estrogen hormone, making them a safe and effective birth control option for breastfeeding mothers. 

Estrogen's presence can potentially affect the hormones related to breastfeeding, but progestin-only methods help avoid this issue. 

Is there any time in the menstrual cycle for the sub-dermal implant to be inserted?

The subcutaneous implant can be inserted at any time during the menstrual cycle. There is no specific timing requirement for its insertion. It can be done regardless of whether you are on your period or not. However, if it's inserted during the early days of your period, it becomes effective immediately in preventing pregnancy. 

If it's inserted at other times in your cycle, using a backup birth control method like a condom may be recommended for a certain period to ensure contraception effectiveness.

How successful is a sub-dermal implant in preventing pregnancy? 

The birth control implant is highly effective at preventing pregnancy when used correctly. Its typical failure rate is very low, ranging from 0.05% to 0.2%. When used perfectly and inserted at the right time, it becomes even more effective. If inserted during the early days of a period, it works immediately. 

However, if inserted at other times in the menstrual cycle, a backup birth control method may be recommended for a certain period to ensure effectiveness. It's important to remember that the implant does not protect against sexually transmitted infections (STIs).

What are the side effects? 

Some common side effects that may occur when using the implant include irregular periods, spotting, breast tenderness, mood changes, or headaches. However, these side effects can vary from woman to woman, and some women may not experience any side effects at all.

Some women may experience irregular periods or spotting when using the implant, but these effects can vary among individuals.

Is it available in India? What is the cost? 

In India, you can consult either a private or government hospital for getting an implant. Implants may also be available in government hospitals, but their availability may vary depending on specific regions or facilities.

The cost of the implant depends on the brand and the doctor but it can be anywhere from 3000 to 5000 rupees. You can inquire about the price and availability from your doctor or family planning clinics.

There may be separate fees for insertion and consultation. Some prominent subcutaneous birth control implant brands available in India include Nexplanon, Implanon NXT and Sino-implant (II). 

Advantages of sub-dermal implant

The subcutaneous birth control implant offers several significant advantages. It is highly effective, with a low failure rate when used correctly, providing extended protection for 3 to 5 years. Additionally, it is easily reversible, allowing for a swift return to fertility upon removal. The implant eliminates the need for daily reminders, providing discreet and private contraception. 

Its hormone-based nature, specifically progestin-based, makes it suitable for individuals who cannot use estrogen-based contraceptives due to health reasons. Moreover, some users benefit from reduced menstrual flow or even the absence of periods, particularly helpful for those with heavy or painful menstrual cycles.

Disadvantages of sub-dermal implant

While the subcutaneous/sub-dermal birth control implant offers effective contraception, it may present some drawbacks. Irregular bleeding, including spotting and unpredictable periods, is a common side effect for certain users. Initial side effects such as breast tenderness, mood changes, or headaches may also be experienced. Insertion and removal of the implant require a minor medical procedure, potentially causing temporary discomfort.  

Importantly, it does not provide protection against sexually transmitted infections (STIs). There can be an initial cost associated with the implant and its insertion procedure, which may be higher than some other birth control methods, although it often balances out over time due to its long-lasting protection. Additionally, the need for a doctor to insert and remove the implant may not be easily accessible in all areas. While uncommon, some users may report weight gain as a side effect. 

Do periods stop completely after the sub-dermal implant? 

The effect of the birth control implant on menstrual periods varies among individuals. While some may experience lighter or even absent periods, others may have irregular bleeding or no change in their menstrual cycle. 

It's not guaranteed that periods will stop completely for everyone using the subcutaneous implant. Individual experiences can differ, and any concerns should be discussed with a healthcare provider for personalized guidance.

Can the sub-dermal implant be used by teenagers? 

Yes, the birth control implant can be used by teenagers. In fact, it is a suitable option for many teenagers who are sexually active and looking for long-lasting contraception. However, the decision to use any form of birth control should involve a discussion between the teenager, their parents or guardians (if applicable), and a doctor. 

The doctor can assess the teenager's individual health, needs, and preferences and provide guidance on the best contraceptive options. It's important to ensure that teenagers have accurate information about their choices and the importance of using contraception consistently and correctly to prevent unintended pregnancies and protect against sexually transmitted infections (STIs). 

Is there any age limit for sub-dermal implants? 

Typically, there are no upper age restrictions for using the birth control implant. It can be a suitable option for individuals of various ages, including women who have had children and those who have not. 

The decision to use the implant should be based on individual health considerations and contraceptive needs. Older individuals may find the long-term protection and convenience of the implant appealing. 

However, as with any contraceptive method, it's important to consult with your doctor to assess whether the implant is the right choice of contraceptive for you. 

Can the sub-dermal implant migrate or get lost inside the body? 

It is highly unlikely for the birth control subcutaneous implant to migrate or get lost inside the body when inserted by a qualified healthcare provider. The implant is a small, flexible rod that is placed just beneath the skin on the inside of the upper arm. It is inserted using a specialized applicator, ensuring that it remains securely in place. 

Over time, the body naturally forms a tissue capsule around the implant, helping to keep it in position. While very rare, if a person experiences unusual sensations or discomfort at the implant site or suspects a problem with its placement, they should contact their healthcare provider promptly. Routine self-check-ups and with a doctor can help ensure that the implant is properly located and functioning as intended.

To protect the identity, the person in the picture is a model and names have been changed. 

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