Methods
Is the implant completely safe?
Quick answer
No medicine is completely safe for every person, but the implant is one of the safest and most effective methods there is. WHO says almost anyone can use it, including young people and those who have never given birth.[src] The main downside is changed bleeding. Problems with insertion or removal are uncommon.
What WHO says
WHO's Medical Eligibility Criteria (WHO Medical Eligibility Criteria: who can safely use each method.) rate every method for every health condition on a scale of 1 to 4, where 1 means no restriction and 4 means do not use.[src] The implant is category 1 or 2 for most situations, including teenagers, people who have never been pregnant, breastfeeding mothers, smokers of any age, people with high blood pressure, and people with migraine with aura who cannot take estrogen.[src] Because it has no estrogen, it avoids the main clot risk of combined pills.
It is also not an abortifacient. In November 2017 the FDA declared all 51 contested contraceptive products non-abortifacient, and DOH said the court order that had stopped implant distribution was effectively lifted.[src]
Who should talk it through first
A few conditions move the implant to category 3 or 4, meaning a doctor should weigh it carefully or choose something else:[src]
- Current breast cancer, or breast cancer in the past.
- Unexplained vaginal bleeding that has not been checked yet.
- Some serious liver disease or liver tumors.
- A blood clot in the legs or lungs happening right now.
- Lupus with antiphospholipid antibodies.
Some medicines make the implant less effective, especially rifampicin (used for TB) and certain epilepsy medicines.[src] Tell the provider everything you take. See do antibiotics stop birth control working.
Insertion and removal risks
Insertion takes a few minutes with a local anesthetic. The WHO handbook lists bruising, soreness and a small chance of infection at the site.[src] A rod placed too deep can be harder to feel and to remove, which is why a trained doctor, nurse or midwife should do it. Removal leaves a tiny cut that heals in days.
One real-world risk in the Philippines is not medical: an expired implant left in because a facility refused to remove it. Filipinas on Reddit report being turned away at a barangay health center.[src] An expired implant is not toxic; it just stops working. You have a right to ask for removal, and another facility can do it.
Side effects that are not dangerous
The most common effect is changed bleeding: irregular spotting, longer bleeds or no bleeding at all.[src] None of these harm you, but they are the main reason people remove it early. Some people get headaches, sore breasts, acne or mood changes.[src] Fertility comes back quickly after removal.[src] More in Hindi na ba magkakamens sa implant?
When to get checked
See a provider soon if
- The arm becomes red, hot, swollen or oozes pus after insertion.
- You cannot feel the rod any more.
- You have very heavy bleeding, severe belly pain, or think you might be pregnant.
Frequently asked questions
Safe ba ang implant kahit wala pang anak?
Oo. Ayon sa WHO, puwede ang implant kahit hindi pa nanganganak, pati sa mga kabataan. Kung tinanggihan ka dahil wala kang anak, puwede kang lumapit sa ibang provider.
Can the implant move around my body?
It usually stays where it was placed under the skin of the upper arm. Moving far from the site is rare. If you can no longer feel it, see a provider and use condoms until it is found.
Does the implant cause cancer?
WHO lists current or past breast cancer as a reason to choose another method, because the implant contains a progestin. That is a caution for people who already have breast cancer, not evidence that the implant causes it.
This guide is for information. Talk to a doctor before starting, stopping or switching birth control.
Sources
- Medical eligibility criteria for contraceptive use, World Health Organization
- Family Planning: A Global Handbook for Providers, WHO and Johns Hopkins CCP
- TRO on contraceptives now lifted: DOH, Philstar, 15 Nov 2017
- Drug interactions with hormonal contraception (guideline), FSRH (UK) Added during build. [TODO: link the exact guideline page]
- Barangay health center refused to remove my implant, r/adviceph
- When will fertility return after using hormonal contraception?, Patient.info