shop Lola

The birth control implant: our guide to the most underrated form of birth control

The birth control implant: our guide to the most underrated form of birth control

I don’t know about you, but I don’t know of any women using the birth control implant. Sure, I know tons of women who use the pill, an IUD, condoms, or even some who have gotten their tubes tied, but a birth control implant? Not one. According to Dr. Laura MacIsaac​, an OB-GYN ​and director of family planning for Mount Sinai Health System, my friends aren’t just a weird sub-group. She calls the implant one of the most underappreciated, yet most effective methods of birth control. So, I knew it was high time to check it out.

What is the birth control implant?
The implant is a tiny, matchstick-shaped rod, about 1.5 inches in length, that is inserted under the skin in your upper arm. It has a whopping 99.95% effectiveness in preventing pregnancy and lasts for up to three years, at which point it needs to be replaced. Women looking to get pregnant or who don’t like the side effects (more on that later) can have the implant removed at any time.

Insertion and removal are both easy procedures, lasting just a few minutes. For insertion, your doctor will numb the area with a topical painkiller and insert the rod using a preloaded, single-use device. Then, upon removal, the doctor needs to make a small incision to remove it. If you decide to re-up after your three years, the rod can be reinserted in the same spot.

Once implanted, you can’t see the rod, though you may be able to feel it if you touch the area.

How does it work?
Just like some birth control pills and IUDs, the implant prevents pregnancy by releasing the hormone progestin into the bloodstream. Progestin suppresses ovulation, in other words it keeps your eggs from leaving the ovaries, and makes your cervical mucus so thick that sperm can’t reach your eggs to fertilize them.

How many women have the implant?
When I said my friends weren’t a weird sub-group, I wasn’t lying. A 2012 study showed that just over 1% of women that use birth control relied on the implant (even though it’s been around since 1993), compared to 17% of women who rely on the pill.

The benefits of using the implant
As with any other form of contraception, the birth control implant has both pros and cons. One major benefit is that you don’t have to do anything for it to work. Once it’s in, you can forget about it for three years, which is a lot better than having to take a pill every day (and freaking out when you miss a dose… or two… or three…).

It’s also incredibly effective. According to the American Congress of Obstetricians and Gynecologists (ACOG), the implant is as effective as an IUD (intrauterine device), birth control pills, and sterilization. However, it doesn’t protect against STDs, so you’ll still have to use a condom if that’s a concern.

It’s also incredibly effective.

Another advantage to the implant if you’re planning to have children: once the rod is removed, you can quickly become pregnant again. In fact, most women return to ovulating within three weeks. And while we’re on the topic of kids, the implant is safe to use while breastfeeding.

Finally, an added bonus is that most women will find their periods becoming shorter and lighter, and after one year, one out of three women who use the birth control implant will stop having periods completely until you remove the device.

So what’s not to like?
At this point you may be thinking: what’s the catch? The implant sounds too good to be true!

Well, for some women, a major downside to using the birth control implant is that it can cause irregular periods and unpredictable spotting between cycles particularly during the first year of use. In fact, one in ten women get the implant removed for that reason. Other potential side effects (which are common to most hormonal forms of birth control, like the pill and IUDs), include mood changes, weight gain, headaches, decreased sex drive, and nausea.

Lastly, a minority of women shouldn’t use the implant, namely breast cancer patients or survivors. Though it’s not currently known whether the implant can increase a woman’s risk for breast cancer, it’s best to avoid it if you’ve had or have a cancer that is hormone-sensitive.

So, should I get it?
Since the majority of women won’t experience any bothersome side effects, the decision to use this form of contraception is really a matter of personal preference.

When making the decision, many women compare the implant to IUDs, which are similar in many ways. Both forms of contraception are long-lasting and reversible. Additionally, both are inserted into the body, require no maintenance on the part of the user, and secrete hormones to prevent pregnancy (except for the Paragard Copper T, a non-hormonal IUD).

Some of the factors you’ll want to consider when weighing your options are the difference in cost (check with your insurance); duration of effectiveness (3 years for the implant vs. 5 years for the Mirena IUD, and 10 for the Copper T IUD), and the risk of serious side effects. Though rare, the IUD can perforate the uterine wall during insertion (happening in about 1 in 1,000 cases) and can cause Pelvic inflammatory disease (PID), an infection of the uterus and fallopian tubes, in fewer than 1 in 100 women. Whereas, serious side effects associated with the implant are extremely rare.

Naturally, you may try either the IUD or implant and find that they’re not a good choice for you, perhaps because the IUD fell out of your uterus (which happens to about 5% of women) or because the implant caused irregular and unpredictable bleeding. The good news is that you now have a great backup in case your first choice doesn’t work out.