Contraceptive Implant: Pros, Cons, Cost, and What to Know

What Is a Contraceptive Implant?

A contraceptive implant is a long-term, highly effective contraceptive method that involves placing a small rod (matchstick-sized, about 4 cm long and 2 mm in diameter) under the skin of the inner upper arm. The rod contains progestogen hormone (etonogestrel) that is gradually released at very low doses, working through three main mechanisms:

1. Prevents ovulation — Suppresses LH hormone from the pituitary gland, preventing the ovaries from releasing eggs.
2. Thickens cervical mucus — Creates a barrier preventing sperm from passing through.
3. Thins the uterine lining — Reduces the chance of embryo implantation (secondary mechanism).

Effectiveness: over 99.95% — the highest of all available contraceptive methods, including sterilization. This figure comes from large clinical studies worldwide.

BSCKI. Trần Thị Thúy Lâm, with over 30 years of experience in obstetrics, gynecology, and family planning, states: “The contraceptive implant is one of the most modern and safest contraceptive methods available today, especially suitable for women wanting long-term contraception without worrying about taking daily pills.”

Types of Contraceptive Implants Available

There are currently two main types of contraceptive implants on the market:

Implanon NXT (Nexplanon)

• Most commonly used in Vietnam and worldwide
• Contains 68 mg etonogestrel
• Duration of use: 3 years
• Contains radio-opaque material, easy to verify position by X-ray
• Approved by WHO and Vietnam’s Ministry of Health

Two-Rod Implant (Jadelle, Sino-implant)

• Consists of 2 small rods containing levonorgestrel
• Duration of use: 5 years
• Commonly used in national family planning programs

Comparing Implants with Other Contraceptive Methods

Read more: Detailed comparison of all safe contraceptive methods

Advantages of Contraceptive Implants

1. Highest effectiveness — 99.95%, nearly absolute. Out of 10,000 women using an implant for 1 year, only about 5 will have an unintended pregnancy.
2. Long-lasting — 3-5 years depending on type, no need to remember daily pills or make any daily changes. Especially convenient for busy women.
3. Quick fertility recovery — After removal, fertility returns within 1-3 months. Many women conceive in the very first menstrual cycle after removal.
4. Safe while breastfeeding — Contains only progestogen, no estrogen, so it does not affect breast milk quality or quantity. Can be inserted from 6 weeks postpartum.
5. Reduces period pain — Many women report reduced or eliminated period cramps after implant insertion.
6. Reduces menstrual flow — About 20% of women stop menstruating entirely, 30% have lighter and less frequent periods. This benefits women with menstrual disorders with heavy bleeding.
7. Discreet — The rod sits under the skin, invisible from outside. Only detectable by touch if you know the exact location.
8. Suitable for many women — Including those who cannot use estrogen (history of thrombosis, migraine with aura, hypertension).

Disadvantages and Side Effects

Disadvantages

1. Menstrual changes — The most common side effect. About 20% experience irregular bleeding in the first 3-6 months, which usually stabilizes. This is the main reason women request early removal.
2. Does not protect against STDs — Need to combine with condoms if at risk.
3. Requires a trained doctor for insertion and removal — Cannot be done at home.
4. Higher initial cost compared to condoms or monthly pills (but cheaper per year on average).

Possible Side Effects

• Headache — Usually mild, decreases after a few weeks
• Acne — Some women experience more breakouts due to hormones
• Slight weight gain — Average 1-2 kg/year, not significant compared to non-users
• Mood changes — Rare, consult doctor if severe
• Breast tenderness — Usually mild and temporary

Note: Most side effects are mild and tend to decrease after 3-6 months as the body adjusts to the hormone.

Detailed Insertion Procedure

Before Insertion

• Gynecological exam, rule out pregnancy with a test or beta-hCG blood test
• Thorough counseling about mechanism, possible side effects, and setting realistic expectations
• Choose insertion timing: Best within the first 7 days of the menstrual cycle (for immediate contraceptive effect)
• If breastfeeding: insert from 6 weeks postpartum
• After miscarriage/abortion: can insert immediately

During Insertion

1. Patient lies on their back, arm for insertion (usually non-dominant hand) extended to the side, forearm flexed
2. Identify insertion site: inner upper arm, 8-10 cm from the elbow crease
3. Thoroughly disinfect the insertion area
4. Local anesthesia with lidocaine — small needle, virtually painless
5. Insert the rod under the skin using a specialized applicator, just beneath the dermis
6. Verify position by touch — both ends of the rod should be palpable
7. Apply pressure bandage
8. Total time: 3-5 minutes

Post-Insertion Care

• Keep pressure bandage for 24 hours, adhesive strip for 3-5 additional days
• Avoid heavy lifting with the insertion arm for 2-3 days
• Mild bruising at the insertion site may occur, resolving within 1-2 weeks
• No need to avoid bathing, but keep the insertion site clean
• Contraceptive protection is immediate if inserted within the first 7 days of the menstrual cycle. If inserted at other times, use condoms for 7 days.
• Follow-up checkup after 1 month

Removal Procedure

• Similar local anesthesia
• Doctor makes a small incision (2-3 mm) at the rod end, uses forceps to extract
• Time: 3-5 minutes if the rod is in normal position
• A new rod can be inserted at the same site if continued contraception is desired

Who Should and Should Not Use Implants?

Especially Suitable For

• Women wanting long-term contraception (3-5 years) without daily concerns
• Breastfeeding women (from 6 weeks postpartum)
• Women who cannot use estrogen: history of venous thrombosis, migraine with aura, severe hypertension, liver disease
• Women who frequently forget daily pills
• Women with severe period pain or heavy menstrual bleeding
• Women with severe premenstrual syndrome

Not Suitable (Contraindications)

• Currently pregnant or suspected pregnancy
• Breast cancer currently being treated or history of breast cancer
• Severe liver disease (cirrhosis, liver tumor)
• Unexplained vaginal bleeding — needs examination and diagnosis first
• Allergy to implant components (etonogestrel)
• Currently taking certain anti-epileptic drugs (rifampicin, phenytoin) — reduces implant effectiveness

Requires Careful Consideration

• Women with severe depression
• History of thrombosis (consult doctor)
• Diabetes with vascular complications

Common Questions About Contraceptive Implants

Does the implant cause infertility?

Absolutely not. This is a common concern but has no scientific basis. The implant’s effect is completely reversible. After removal, the hormone is cleared from the body within days and fertility fully recovers within 1-3 months.

Does the implant affect sexual intercourse?

No. The rod sits under the arm skin, completely unrelated to the genital area. Some women actually find their sex life more relaxed because they don’t worry about unplanned pregnancy.

Can the rod break or migrate?

The rod is very durable and unlikely to break under normal conditions. Migration is extremely rare (less than 1%). You should periodically check by feeling the rod under the skin. If you cannot feel it, see your doctor immediately.

Does the implant interact with any medications?

Some medications may reduce effectiveness of the implant:

• Anti-epileptic drugs: phenytoin, carbamazepine, phenobarbital
• Anti-tuberculosis drugs: rifampicin, rifabutin
• Some HIV antiretroviral drugs
• Herbal supplement: St. John’s wort

If taking any of these medications, inform your doctor for advice on a suitable contraceptive method.

When Should You See a Doctor After Implant Insertion?

Contact your doctor immediately if:

• Cannot feel the rod under the skin — it may have migrated or been inserted too deep
• Severe pain at the insertion site lasting more than 1 week
• Swelling, redness, pus at the insertion site — signs of infection
• Heavy vaginal bleeding lasting more than 2 consecutive weeks
• Suspected pregnancy (very rare but possible)
• Severe lower abdominal pain — to rule out ectopic pregnancy
• Jaundice, pain in the liver area — rare liver side effect
• Want to have the implant removed for any reason

Practical Tips for Implant Users

1. Be patient during the first 3-6 months: Menstrual changes are the most common side effect but usually stabilize after 3-6 months. Don’t rush to remove it early.
2. Check the rod regularly: Each month, gently feel the insertion site to ensure it’s still in place.
3. Remember the insertion date: So you know when a new rod is needed (after 3 or 5 years depending on type).
4. Never remove it yourself: Always visit a healthcare facility with a trained doctor for safe removal.
5. Combine with condoms if at risk of sexually transmitted diseases.

Contraceptive Implants at Phòng Khám Bác Sỹ Lâm

Phòng Khám Sản Phụ Khoa Bác Sỹ Lâm is one of the trusted facilities in Lao Cai providing comprehensive family planning services, including contraceptive implants.

BSCKI. Đinh Thị Hiền — a doctor at the clinic — holds a certified qualification in contraceptive implant insertion issued by the Ministry of Health, ensuring safe and proper technique. The clinic is fully equipped with sterile instruments to standard.

Clinic procedure:

• Free consultation before deciding
• Gynecological exam to rule out contraindications
• Quick, gentle implant insertion (3-5 minutes)
• Detailed post-insertion care instructions
• Follow-up and management of side effects if any
• Removal when expired or when desired

Considering the right contraceptive method for you? Visit Phòng Khám Bác Sỹ Lâm for a free consultation and choose the best option.

Call now: 0986 321 000 | Address: 125 Hàm Nghi, Kim Tân, Lào Cai

The clinic is open Monday to Saturday, morning 7:30-11:30, afternoon 1:30-5:00. Appointments accepted by phone and Zalo.