Contraceptive implant (Implanon NXT®)

The Implanon NXT® contraceptive implant is also known as the ‘rod', the ‘stick' or the Implant.

The implant is a small rod inserted under the skin of the arm using local anaesthetic, and slowly releases the hormone progestogen. It can be removed any time before or replaced at three years.

  • A plastic, flexible rod (about the size of a matchstick) is inserted just under the skin in the inner upper arm to prevent pregnancy
  • Safe, effective and convenient
  • Available only by prescription - must be inserted by a health care provider
  • Lasts up to three years
  • A LARC (long-acting reversible contraception) – most cost-effective

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How does Implanon NXT® work?

Implanon NXT® works for three years by:

  • Preventing ovulation (egg release from the ovary)
  • Thickening of the mucus of the cervix so that sperm cannot enter the uterus (womb)
  • Changing the lining of the uterus, making it unsuitable for pregnancy

What are the advantages of Implanon NXT®?

  • Highly effective (99.9%). This means that fewer than one woman in every hundred using this method of contraception for a year would become pregnant
  • Long-acting (lasts three years)
  • Reversible and rapid return to usual fertility (most women ovulate within the first month after removal of the implant)
  • Inexpensive – cost effective
  • A small percentage of women have no vaginal bleeding
  • Less period pain for some women
  • No pills – no injections

What are the disadvantages of Implanon NXT®?

A change to the pattern of vaginal bleeding is the most noticeable result of using the implant. The changes are due to the effect of the hormone on the lining of the uterus. It is not possible to predict what the pattern will be for any one woman. Changes can include:

  • changes in bleeding frequency (about one in every five women have no bleeding at all)
  • irregular light bleeding
  • prolonged and/or frequent light bleeding
  • prolonged and/or frequent heavy bleeding

The type of bleeding pattern experienced in the first 3-6 months of use may predict the ongoing pattern.

For women experiencing continued bleeding problems, a change of contraceptive method may need to be considered.

Women who are unhappy with their bleeding pattern should talk to their doctor.

Other disadvantages or possible risks of Implanon NXT®?

  • It does not protect against sexually transmissible infections (STIs)
  • It requires a minor procedure for insertion and removal
  • Some women experience skin bruising when it is first put in the arm and a small scar
  • Difficulty in removing the implant (which may result in additional scarring)
  • Allergic reaction to the local anaesthetic or implant material (rare)

Possible side effects of Implanon NXT® include:

  • Headaches
  • Mood changes
  • Breast tenderness
  • New onset acne

Does Implanon NXT® suit all women?

Most women can safely use Implanon®. Your doctor will review the suitability of the method with you prior to insertion.

Who cannot use Implanon NXT®?

This method is not suitable for women with:

  • a history of breast cancer
  • unexplained vaginal bleeding (your doctor will need to investigate this prior to the insertion of the implant)
  • certain medications which may prevent the contraceptive implant from working effectively

How is the contraceptive implant inserted and removed?

A local anaesthetic is given into the skin and, when the area is numb, the implant is inserted. The implant is usually placed on the inside of the upper arm.

The implant is normally inserted during the first five days of the menstrual period but it can be inserted at other times if there is no chance that the woman could already be pregnant.

If it is inserted in the first five days of the menstrual period it may be immediately effective.

If it is inserted at other times it will not be effective for seven days.

The implant can be left in the arm for three years (or removed earlier if desired). Removal is a simple procedure using a small amount of local anaesthetic.

You should expect intermittent spotting or bleeding for up to 6 months while the implant settles in.

A follow up visit will be made to check on the placement and the bleeding pattern.

Fertility after an implant?

When the implant is removed fertility returns quickly with most women returning to their previous menstrual cycle within a month. If you do not wish to fall pregnant, you must consider alternate methods of contraception straight away. The implant is not effective after three years so it should be removed and the same or another contraceptive method used. A single procedure can be used to remove an old implant and put in a new one.

The implant should be removed after 3 years even if you no longer require contraception. If a pregnancy occurs with an expired Implanon NXT® in place, then there is a small increased risk of the pregnancy implanting in the fallopian tube (ectopic pregnancy). This can be a serious condition.