Contraceptive implant: is it worth it?

Read an interview with Doctor Marek Kwiecień, a gynaecologist working at the Medfemina Health Centre in Wrocław, about the use of the Implanon contraceptive implant

Contraceptive implants have finally arrived in Poland, can you tell us something about this method of contraception?

Marek Kwiecień, MD: The contraceptive implant is a flexible, 4 cm long, plastic rod that is inserted subcutaneously, containing a progressively released progestogen hormone, used to protect against unwanted pregnancy. This implant has been on the market for over a dozen years and is successfully used all over the world. I have been using this method with my patients for several years and it may not have been as popular as in the UK, but it is now gaining a lot of fans. My observations prove that it meets their expectations. Contemporary women strive to ensure that contraception does not absorb their memory, is invisible to others and is long-lasting in its use. Implanon is a system that guarantees all of the above aspects. Importantly, it has an extremely low Pearl coefficient, which means it is highly effective as a contraceptive – it does not rely on regular pill-taking, so it is not possible to miss a dose. Neither diarrhoea nor vomiting affect its efficiency, it is enough to record the date of its insertion and removal on a special card. I am very pleased that a modern, safe and long-term contraceptive method is now easily available also for patients in Poland.

How long can an implant be used and how is it applied?

Marek Kwiecień, MD: The subcutaneous implant is placed under the skin on the inner side of the arm between the muscles; it is a quick and simple procedure and its painlessness is guaranteed by prior local anaesthesia of the arm area.

The system remains there for three years and after this period it should be removed and replaced with a new one, as the release of the contraceptive active substance into the bloodstream ends. Removing the implant is also a short and painless procedure. It can be performed whenever the patient or the doctor deems it appropriate, also when the woman decides to get pregnant before the end of the system’s operation period without any negative impact on fertility.

When can the Implanon system be inserted?

Marek Kwiecień, MD: It depends on the situation of the potential candidate and I always assess this during the visit, if it is the first-time procedure it’s between 1-5 days of the cycle, always make sure the patient is not pregnant beforehand. The system works from the start of insertion and no other contraceptive method is required. If the patient has used another method before, depending on the type of method, I make the decision about the placement on an individual basis.

Is it also safe for breastfeeding women? 

Marek Kwiecień, MD: Yes. One of the advantages of the implant is that it contains a hormone that has been scientifically proven safe for use in nursing mothers and can be successfully used as early as 4 weeks after childbirth.

Are there any restrictions on the use of this type of contraception?

Marek Kwiecień, MD: As with other single-ingredient methods, such as the gestagen pill, the hormone IUD or injectable contraceptives, the limitations to the use of the implant include active thromboembolic disease, a malignant tumour dependent on sex hormones, severe liver disease or vaginal bleeding of unknown cause. The same applies to the side effects that sometimes occur during the use of this method of contraception, the most common of which are changes in menstrual bleeding – irregular bleeding patterns, headaches, nausea, breast tenderness. Age is also a limitation – the preparation has not been registered for use under 18 years of age.

What is the price in a wide range of contraceptives?

Marek Kwiecień, MD: If we take the average price of PLN 40 for a pack of contraceptive pills used for 36 months, the cost of installing and removing the implant will be similar. Remember, however, about the convenience and the lack of the need for making appointments „to get another prescription”. Of course, I recommend that patients who use Implanon have a routine check-up, but it is possible at a more convenient time for a patient, and not as usual at the last minute – because the pills have already run out.