Discreet, the diffuse contraceptive implant of hormones in the blood in order to block ovulation. How is the pose in the arm? The withdrawal? What is its price? What are its effects? Dangers? Does he gain weight? Lower libido? Explanations from Dr. Claude-Isabelle Blanchet, gynecologist in Paris.
Due to long action, The contraceptive or hormonal implant is a contraceptive method that is not chosen lightly. What is it precisely? How does it work? Does it have side effects or an influence on weight gain? Libido? Answers.
Definition: What is a contraceptive implant?
The contraceptive implant is a small flexible and cylindrical stick, in plastic, 4 cm long and 2 mm in diameter. Once put in place (in the arm), the implant is almost invisible and absolutely does not feel. It continuously delivers a micro-progestogen (hormone) directly in the blood.
What is the mode of action of a contraceptive implant?
“The contraceptive implant is a micro-progestogen that continuously delivers a female hormone (etonogestrel) broadcast directly in the blood, blocking ovulation. It does not contain estrogens, unlike the contraceptive pill or patch“, explains Dr. Claude-Isabelle Blanchet, gynecologist in Paris. In France, the name of the implant is Nexplanon®, replacing the Implanon® put on the French market in May 1999.
What is the effectiveness of the contraceptive implant?
The contraceptive implant is efficient at 99.9 % (the remaining 0.1 % is due to the extremely rare cases of bad manipulations during the installation) and this, during 3 years.
For which women is the contraceptive implant indicated?
The implant can be prescribed to women whose estroprogestative contraceptives or the IUD (intrauterine device: sterilet) are contraindicated or who have tendency to forget their pill For example. “The implant is contraindicated in case of phlebitis, pulmonary embolism, tumor sensitive to sex hormones, unexplained vaginal bleeding and serious liver pathologies”specifies Dr. Claude-Isabelle Blanchet.
An hour before installation, the gynecologist, the doctor or the midwife applies an anesthetic cream or patch. To facilitate the insertion of the implant, you must lie on your back, with your arm Slightly folded at the elbow and turned outwards. The practitioner inserts the implant under the skin of the arm Non-dominant (left arm if you are right-handed and vice versa), above the elbow fold, using a needle as for a vaccine. The installation of a contraceptive implant is fast and does not hurt. Contraception is active 24 hours after the implant installation But it is advisable to combine it with another means of contraception as a condom during the first 15 days. A visit to the doctor is also recommended 3 months after installation to verify that the implant is not lost in the body. Apart from this medical control, The implant does not require any particular follow -up.
In the same way as the installation, the withdrawal of the implant is carried out by a doctor, a gynecologist or a midwife, necessarily under local anesthesia (cream, anesthetic patch and/or supplemented by an injection of lidocaine, a local anesthetic capable of inhibiting the transmission of nervous influx). The professional then performs a small incision above the implant to remove the stem using a small pliers. Remember that the withdrawal of an implant is Easy, fast and painless. If you have nausea or other side effects after removing the implant, do not hesitate to consult your doctor.
Do we still have its rules with the contraceptive implant?
It depends. Some women no longer have their rules (the implant having an impact on ovulation and the menstrual cycle). This is the case of 20 to 30% of women. Most women (between 50 and 60%) have less abundant and less frequent rules. A minority of women (10%) have very frequent bleeding during the first 6 months of the implant.
What are the side effects of the contraceptive implant?
The implant can causeacne in some women and influence the Flow of their menstruation : Some will have less frequent rules, sometimes shorter or longer than usual. Some women may have a total absence rules. It is not dangerous for health, but it is better to talk about it consult your doctor to possibly consider a more suitable contraceptive. Finally, “It may be that bleeding appear, especially the first 6 months after the implant, because the progestin will also make the internal wall of the endometrium (the uterus) which can then bleed, which can be embarrassing and tiring. If bleeding is very frequent, it is prudent to consult a doctor “, recommends the gynecologist. Moreover, Taking certain drugs can make it less effective : Like those to treat epilepsy, tuberculosis, but also anti-depressants based on St. John’s Day.
Does the contraceptive implant make you fat?
The reaction in the face of hormonal contraception as the contraceptive implant is very variable from one woman to another: the diffusion of continuous progesterone in the body leads to a modification of the hormonal balance and can open the appetite of certain women, while others will not notice any change concerning their hunger or their weight. However, it is true that “As with any hormonal contraception (contraceptive patch, vaginal ring, pill …)the implant can generate certain side effects such as weight gain In some overweight women. For a weight of more than 80 kilos, it is advisable to change the implant after 2 years, the dose of hormones that can be insufficient to allow optimal protection over 3 years“, Specifies the expert.
Does the contraceptive implant have an impact on libido?
All contraceptions that deliver hormones can have repercussions on libido. But again, this decrease (or increased by the way) is variable from one woman to another. If you notice a drop in libido and it bothers you, talk to your doctor. By discussing your intimacy, your lifestyle or your health history, it will be able to give you explanations on your drop in desire and see if there are no other reasons (couple problems, psychological reasons, diseases …). If this is very problematic for you, consider another contraceptive method, possibly without hormones like the COPIP.
What are the long -term risks of a contraceptive implant?
The Nexplanon® implant has been associated with risks Neurovascular lesions instead of his insertion and migration in blood vessels and in the chest.
What is the price of a contraceptive implant and is it reimbursed?
The implant is prescribed by a doctor or a midwife, and is issued in pharmacy on medical prescription. Its indicative price is 106.44 euros. The contraceptive implant is Refunded at 65% by social security. Remember that a visit to your general practitioner, your gynecologist or midwife will also be necessary to place this hormonal contraceptive, but also to remove it.
On the Health Forum: discussions about the contraceptive implant
Retain
► The contraceptive implant blocks ovulation and can sometimes delete the rules.
► It does not contain estrogens unlike the contraceptive pill or patch.
► Contraception is active 24 hours after the implant installation but it is advisable to put a condom during the first 15 days.
► All contraceptions that deliver hormones can have repercussions on libido.
► The implant is prescribed by a doctor or a midwife, and is issued in pharmacy on medical prescription.
Thank you to Dr Claude-Isabelle Blanchet, gynecologist in Paris.
